Individual
TATE GUILD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2801 W CHARLESTON BLVD STE 100, LAS VEGAS, NV 89102-1965
(702) 877-6608
(702) 877-0038
Mailing address
2801 W CHARLESTON BLVD STE 100, LAS VEGAS, NV 89102-1965
(702) 877-6608
(702) 877-0038
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6779
NV
Other
Enumeration date
06/06/2016
Last updated
06/06/2016
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