Ada Nevada Dental LLC

NPI #1154084309 in Las Vegas, Nevada

Provider Information

NPI Number: 1154084309
Entity Type: Organization
Organization Name: Ada Nevada Dental LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Oct 14, 2021
Last Updated: Oct 14, 2021

Practice Location

Address: 5230 BOULDER HWY STE 130
City: Las Vegas
State: Nevada
ZIP Code: 89122-6079
Phone: (702) 851-6724

Authorized Official

Name: GREGORY WALTER GREENWOOD, DMD,PHARMD,MACSD
Title: CLINICAL DIRECTOR
Phone: (504) 952-0344

Specialties & Taxonomy Codes

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

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