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Individual

RYAN JOLLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
1001 SHADOW LN, LAS VEGAS, NV 89106-4124
(702) 774-2400
Mailing address
10116 OCICAT AVE, LAS VEGAS, NV 89166-5254
(702) 574-4768

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
LL-385-14
NV

Other

Enumeration date
12/02/2014
Last updated
12/02/2014
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