Organization
DILETTANTE INC.
Active
Parent organization
RANDY HONG
Other names
Avalon Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
RANDY HONG
Authorized official
PAMELA K PROPSTER (OFFICE MANAGER)
(702) 638-1005
Entity
Organization
Contact information
Practice address
5465 SIMMONS ST, SUITE 4, NORTH LAS VEGAS, NV 89031-9000
(702) 638-1005
(702) 638-1071
Mailing address
5465 SIMMONS ST, SUITE 4, NORTH LAS VEGAS, NV 89031-9000
(702) 638-1005
(702) 638-1071
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4348
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100510098
—
NV
Enumeration date
07/26/2010
Last updated
07/26/2010
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