NPI 1205082450 · live from the CMS NPI Registry
Michael Gardner
Dentist, Orthodontics and Dentofacial Orthopedics in Las Vegas, NV. National Provider Identifier 1205082450, active.
NPI record
| NPI | 1205082450 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Orthodontics and Dentofacial Orthopedics 1223X0400X |
| Practice location | 4610 Meadows Ln, Las Vegas, NV 89107 |
| Practice phone | 702-878-0764 |
| Enumerated | August 7, 2008 |
| Last updated | August 7, 2008 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, Orthodontics and Dentofacial Orthopedics primary | 1223X0400X | S3-81C (NV) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.