Organization
ALTA ORAL SURGERY, LLC
Active
Organization
ALTA ORAL SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENNY KOHANTEB (OWNER)
(702) 435-5015
Entity
Organization
Contact information
Practice address
526 S TONOPAH DR, #200, LAS VEGAS, NV 89106-4043
(702) 435-5015
(702) 366-1483
Mailing address
526 S TONOPAH DR, #200, LAS VEGAS, NV 89106-4043
(702) 435-5015
(702) 366-1483
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
4509
NV
Other
Enumeration date
10/02/2009
Last updated
10/02/2009
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