Anthem Village Dental LLC

NPI #1043362981 in Henderson, Nevada

Provider Information

NPI Number: 1043362981
Entity Type: Organization
Organization Name: Anthem Village Dental LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Jan 18, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 2571 ANTHEM VILLAGE DR
Address 2: SUITE #5
City: Henderson
State: Nevada
ZIP Code: 89052-5508
Phone: (702) 454-7704

Authorized Official

Name: DR. ROBERT WILFORD NISSON, DDS
Title: OFFICER IN CORPORATION
Phone: (702) 454-7704

Specialties & Taxonomy Codes

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

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