Blue Dental, LLC

NPI #1023494838 in Las Vegas, Nevada

Provider Information

NPI Number: 1023494838
Entity Type: Organization
Organization Name: Blue Dental, LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Aug 4, 2015
Last Updated: Aug 4, 2015

Practice Location

Address: 8380 W CHEYENNE AVE
Address 2: 102
City: Las Vegas
State: Nevada
ZIP Code: 89129-8405
Phone: (702) 388-8989

Authorized Official

Name: BENNY KOHANTEB, DDS
Title: OWNER
Phone: (702) 435-5015

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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