Provider Demographics
NPI:1225229016
Name:NEVADA ENDODONTICS LLC
Entity Type:Organization
Organization Name:NEVADA ENDODONTICS LLC
Other - Org Name:NEVADA ENDODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALTERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-243-8102
Mailing Address - Street 1:6950 SMOKE RANCH RD
Mailing Address - Street 2:#125
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-1300
Mailing Address - Country:US
Mailing Address - Phone:702-243-8102
Mailing Address - Fax:702-256-2047
Practice Address - Street 1:6950 SMOKE RANCH RD
Practice Address - Street 2:125
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-1300
Practice Address - Country:US
Practice Address - Phone:702-243-8102
Practice Address - Fax:702-256-2047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty