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Organization

DESERT DENTAL

Active
Parent organization
DESERT DENTAL
Other names
Ilya Benjamin
Organization subpart
Yes

Provider details

NPI number
Legal business name
DESERT DENTAL
Authorized official
DR. ILYA BENJAMIN DMD (OWNER/DOCTOR)
(702) 260-1890
Entity
Organization

Contact information

Practice address
55 S VALLE VERDE DR, SUITE #250, HENDERSON, NV 89012-3433
(702) 260-1890
(702) 260-7936
Mailing address
55 S. VALLE VERDE DR., SUITE #250, HENDERSON, NV 89012
(702) 260-1890
(702) 260-7936

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5852
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1326027095
NV
Enumeration date
07/15/2009
Last updated
07/10/2013
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