Organization
ADA NEVADA DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY WALTER GREENWOOD DMD,PHARMD,MACSD (CLINICAL DIRECTOR)
(504) 952-0344
Entity
Organization
Contact information
Practice address
7670 W LAKE MEAD BLVD STE 160, LAS VEGAS, NV 89128-6649
(702) 957-1487
Mailing address
7670 W LAKE MEAD BLVD STE 160, LAS VEGAS, NV 89128-6649
(702) 957-1487
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/14/2021
Last updated
10/14/2021
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