Provider Demographics
NPI:1043310519
Name:ROYAL DENTAL, L.L.C.
Entity Type:Organization
Organization Name:ROYAL DENTAL, L.L.C.
Other - Org Name:ROYAL DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:702-987-1356
Mailing Address - Street 1:2345 E. CENTENNIAL PKWY.
Mailing Address - Street 2:SUITE 110
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89033
Mailing Address - Country:US
Mailing Address - Phone:702-987-1356
Mailing Address - Fax:702-361-2876
Practice Address - Street 1:2345 E. CENTENNIAL PKWY.
Practice Address - Street 2:SUITE 110
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89033
Practice Address - Country:US
Practice Address - Phone:702-987-1356
Practice Address - Fax:702-361-2876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty