Provider Demographics
NPI:1053497768
Name:WHETTEN, LANCE LOREN (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:LANCE
Middle Name:LOREN
Last Name:WHETTEN
Suffix:
Gender:M
Credentials:DDS MS
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Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:4540 S PECOS RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-5923
Mailing Address - Country:US
Mailing Address - Phone:702-436-0999
Mailing Address - Fax:702-436-2746
Practice Address - Street 1:4540 S PECOS RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-5923
Practice Address - Country:US
Practice Address - Phone:702-436-0999
Practice Address - Fax:702-436-2746
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV937, S3-281223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics