Organization
ADA NEVADA DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY WALTER GREENWOOD DMD, PHARMD, MACSD (CLINICAL DIRECTOR)
(504) 952-0344
Entity
Organization
Contact information
Practice address
5001 E BONANZA RD STE 160, LAS VEGAS, NV 89110-3560
(702) 307-2273
(702) 307-2275
Mailing address
5001 E BONANZA RD STE 160, LAS VEGAS, NV 89110-3560
(702) 307-2273
(702) 307-2275
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
10/14/2021
Last updated
10/14/2021
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