Provider Demographics
NPI:1225166754
Name:GILBERTO SUAREZ JR., D.D.S., P.C.
Entity Type:Organization
Organization Name:GILBERTO SUAREZ JR., D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-656-9977
Mailing Address - Street 1:7730 W CHEYENNE AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-8412
Mailing Address - Country:US
Mailing Address - Phone:702-656-9977
Mailing Address - Fax:702-656-9108
Practice Address - Street 1:7730 W CHEYENNE AVE STE 108
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-8412
Practice Address - Country:US
Practice Address - Phone:702-656-9977
Practice Address - Fax:702-656-9108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty