Provider Demographics
NPI:1851488431
Name:ABSOLUTE DENTAL ALIANTE, INC.
Entity Type:Organization
Organization Name:ABSOLUTE DENTAL ALIANTE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONID
Authorized Official - Middle Name:
Authorized Official - Last Name:BANCHIK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:702-839-2244
Mailing Address - Street 1:3040 W ANN RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:N LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-7265
Mailing Address - Country:US
Mailing Address - Phone:702-839-2244
Mailing Address - Fax:702-839-1415
Practice Address - Street 1:3040 W ANN RD
Practice Address - Street 2:SUITE 101
Practice Address - City:N LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-7265
Practice Address - Country:US
Practice Address - Phone:702-839-2244
Practice Address - Fax:702-839-1415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV45661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty