Organization
LUXE DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTOINETTE BROEDEL (CREDENTIALING SPECIALIST)
(702) 374-1616
Entity
Organization
Contact information
Practice address
2500 W SAHARA AVE STE 202, LAS VEGAS, NV 89102-4367
(702) 633-7500
Mailing address
2001 RAMROD AVE APT 2711, HENDERSON, NV 89014-2392
(702) 374-1616
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/07/2019
Last updated
10/07/2019
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