Provider Demographics
NPI:1225262751
Name:LOUSIGNONT, ADAM (DMD)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:LOUSIGNONT
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9575 W TROPICANA AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-8491
Mailing Address - Country:US
Mailing Address - Phone:702-737-7400
Mailing Address - Fax:702-804-5946
Practice Address - Street 1:9575 W TROPICANA AVE STE 5
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-8491
Practice Address - Country:US
Practice Address - Phone:702-737-7400
Practice Address - Fax:702-804-5946
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-12
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV57891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice