Provider Demographics
NPI:1295231058
Name:MILNE, WESTON JOSEPH
Entity Type:Individual
Prefix:MR
First Name:WESTON
Middle Name:JOSEPH
Last Name:MILNE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:685 MONUMENT POINT ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89002-0506
Mailing Address - Country:US
Mailing Address - Phone:702-469-4648
Mailing Address - Fax:
Practice Address - Street 1:3196 S MARYLAND PKWY STE 307
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-2314
Practice Address - Country:US
Practice Address - Phone:702-623-1633
Practice Address - Fax:520-770-2781
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-02
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVS6-1871223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry