Provider Demographics
NPI:1821326596
Name:DISCOVERY 2000, MERSHA P.C.
Entity Type:Organization
Organization Name:DISCOVERY 2000, MERSHA P.C.
Other - Org Name:DISCOVERY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDOANLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-889-1381
Mailing Address - Street 1:2202 W CHARLESTON BLVD
Mailing Address - Street 2:#10
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-2232
Mailing Address - Country:US
Mailing Address - Phone:702-889-1381
Mailing Address - Fax:702-823-5980
Practice Address - Street 1:2202 W CHARLESTON BLVD
Practice Address - Street 2:#10
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-2232
Practice Address - Country:US
Practice Address - Phone:702-889-1381
Practice Address - Fax:702-823-5980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-18
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV33621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty