Individual
THERESA THAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1001 SHADOW LN, LAS VEGAS, NV 89106-4124
(702) 774-2545
Mailing address
1001 SHADOW LN, LAS VEGAS, NV 89106-4124
(702) 774-2545
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
110231
CA
122300000X
Dentist
8456
NV
Other
Enumeration date
06/25/2024
Last updated
07/20/2026
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