Organization
RAINCHARLIE DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENNY KOHANTEB (OWNER)
(702) 435-5015
Entity
Organization
Contact information
Practice address
945 S RAINBOW BLVD, LAS VEGAS, NV 89145-6230
(702) 331-8585
(702) 382-4469
Mailing address
526 S TONOPAH DR, #200, LAS VEGAS, NV 89106-4043
(402) 435-5015
(702) 366-1483
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
NV20111452524
NV
Other
Enumeration date
12/09/2011
Last updated
12/09/2011
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