Individual
DR. JALEH POURHAMIDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD, MDSC
Contact information
Practice address
4 SUNSET WAY, BUILDING C, HENDERSON, NV 89014
(702) 968-1652
(702) 990-4435
Mailing address
11 SUNSET WAY, HENDERSON, NV 89014
(702) 968-1652
(702) 990-4435
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
LL002703
NV
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
S3-88C
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100506335
—
NV
Enumeration date
12/27/2006
Last updated
08/23/2012
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