Organization
RESIDENTAL
Active
Other names
resiDENTAL
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STEFANIE BERTRAM MPH (OWNER)
(661) 886-3583
Entity
Organization
Contact information
Practice address
5833 FOX HAIR STREET, NORTH LAS VEGAS, NV 89081
(661) 886-3583
Mailing address
5833 FOX HAIR STREET, NORTH LAS VEGAS, NV 89081
(661) 886-3583
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/31/2024
Last updated
06/14/2024
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