Organization
TRACY D WYATT DDS PC
Active
Other names
Wyatt Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRACY D WYATT DDS (PRESIDENT)
(702) 242-9777
Entity
Organization
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
07/22/2008
Last updated
07/22/2008
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