Organization
SHAHRESTANI GRAND CANYON MODERN DENTISTRY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALI SHAHRESTANI (DMD)
(714) 845-8500
Entity
Organization
Contact information
Practice address
9560 W SKYE CANYON PARK DR STE 100, LAS VEGAS, NV 89166-6802
(702) 800-5711
Mailing address
PO BOX 920050, DALLAS, TX 75392-0050
(714) 845-8500
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/07/2024
Last updated
05/07/2024
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