Provider Demographics
NPI:1164609988
Name:FAMILY CARE ORTHODONTICS, INC.
Entity Type:Organization
Organization Name:FAMILY CARE ORTHODONTICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SABA
Authorized Official - Middle Name:
Authorized Official - Last Name:ASRAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:702-575-7871
Mailing Address - Street 1:8409 W LAKE MEAD BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-7638
Mailing Address - Country:US
Mailing Address - Phone:702-254-6700
Mailing Address - Fax:
Practice Address - Street 1:8409 W LAKE MEAD BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-7638
Practice Address - Country:US
Practice Address - Phone:702-254-6700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-23
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVS3-156C1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty