Organization
DODGE A SLAGLE DO LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBRA ELLEN QUINN (BILLING MANAGER)
(702) 454-0201
Entity
Organization
Contact information
Practice address
1090 WIGWAM PARKWAY, SUITE 100, HENDERSON, NV 89074
(702) 454-0201
(702) 454-1245
Mailing address
1090 WIGWAM PARKWAY, SUITE 100, HENDERSON, NV 89074
(702) 454-0201
(702) 454-1245
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
500
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002002729
—
NV
Enumeration date
07/02/2007
Last updated
11/30/2007
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