Individual
KOSTIKA POLENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
8430 FARM RD, STE. 120, LAS VEGAS, NV 89131-8166
(702) 732-1010
(702) 658-6832
Mailing address
526 S TONOPAH DR, STE. 200, LAS VEGAS, NV 89106-4043
(702) 291-2031
(702) 366-1483
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6770
NV
Other
Enumeration date
06/08/2016
Last updated
06/08/2016
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