Individual
DR. TRACY D WYATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7550 W LAKE MEAD BLVD, SUITE 6, LAS VEGAS, NV 89128-1001
(702) 242-9777
Mailing address
7550 W. LAKE MEAD BLVD, SUITE 6, LAS VEGAS, NV 89128-1001
(702) 242-9777
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
S3-163
NV
Other
Enumeration date
08/29/2007
Last updated
06/25/2008
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