Henderson Modern Dentistry

NPI #1083098032 in Henderson, Nevada

Provider Information

NPI Number: 1083098032
Entity Type: Organization
Organization Name: Henderson Modern Dentistry
Primary Specialty: Dentist - General Practice
Enumeration Date: Jul 18, 2015
Last Updated: Jul 18, 2015

Practice Location

Address: 386 W LAKE MEAD PKWY
Address 2: SUITE 100
City: Henderson
State: Nevada
ZIP Code: 89015-7417
Phone: (702) 464-3090

Authorized Official

Name: DR. CODY MUGLESTON, D.M.D.
Title: OWNER DOCTOR
Phone: (702) 464-3090

Specialties & Taxonomy Codes

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

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