Ponce Tender Dental Pd

NPI #1063675973 in Las Vegas, Nevada

Provider Information

NPI Number: 1063675973
Entity Type: Organization
Organization Name: Ponce Tender Dental Pd
Primary Specialty: Dentist - General Practice
Enumeration Date: Jul 10, 2008
Last Updated: Jul 10, 2008

Practice Location

Address: 5230 BOULDER HIGHWAY
Address 2: SUITE 130
City: Las Vegas
State: Nevada
ZIP Code: 89122
Phone: (702) 436-6725

Authorized Official

Name: MONICA RENEE PONCE, DDS
Title: OWNER
Phone: (702) 436-6725

Specialties & Taxonomy Codes

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

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