Provider Demographics
NPI:1518249705
Name:DENTAL ANESTHESIA SERVICES LLC
Entity Type:Organization
Organization Name:DENTAL ANESTHESIA SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STUART
Authorized Official - Middle Name:
Authorized Official - Last Name:WEICHERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-515-1888
Mailing Address - Street 1:6885 ALIANTE PKWY
Mailing Address - Street 2:SUITE 11
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89084-5811
Mailing Address - Country:US
Mailing Address - Phone:702-515-1888
Mailing Address - Fax:
Practice Address - Street 1:6885 ALIANTE PKWY
Practice Address - Street 2:SUITE 11
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89084-5811
Practice Address - Country:US
Practice Address - Phone:702-515-1888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty