Provider Demographics
NPI:1407095409
Name:AARON LAC DENTAL, LTD.
Entity Type:Organization
Organization Name:AARON LAC DENTAL, LTD.
Other - Org Name:ROYAL HIGHLANDS DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:V
Authorized Official - Last Name:LAC
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:702-672-0628
Mailing Address - Street 1:72 PINE BAY CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-2778
Mailing Address - Country:US
Mailing Address - Phone:702-672-0628
Mailing Address - Fax:
Practice Address - Street 1:11350 SOUTHERN HIGHLANDS PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89141-3290
Practice Address - Country:US
Practice Address - Phone:702-834-8228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-13
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental