Provider Demographics
NPI:1851173785
Name:EASTERN FAMILY DENTISTRY LLC
Entity Type:Organization
Organization Name:EASTERN FAMILY DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:D
Authorized Official - Last Name:SOARD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:702-742-5824
Mailing Address - Street 1:1306 W CRAIG RD STE H
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-0215
Mailing Address - Country:US
Mailing Address - Phone:702-633-4333
Mailing Address - Fax:
Practice Address - Street 1:5300 S EASTERN AVE # SITE120
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-2377
Practice Address - Country:US
Practice Address - Phone:702-454-7621
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty