Abraza Dental Group LLC

NPI #1073963757 in Las Vegas, Nevada

Provider Information

NPI Number: 1073963757
Entity Type: Organization
Organization Name: Abraza Dental Group LLC
Primary Specialty: Dentist
Enumeration Date: Jun 14, 2016
Last Updated: Jun 15, 2016

Practice Location

Address: 5642 S EASTERN AVE
Address 2: SUITE B
City: Las Vegas
State: Nevada
ZIP Code: 89119-2375
Phone: (702) 456-0005

Authorized Official

Name: WYATT STOTT DANNELS, DDS
Title: DDS
Phone: (702) 456-0005

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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