| NPI | 1164646295 |
|---|---|
| Doing Business As | LAKE SAHARA DENTAL |
| Entity Type | Organization |
| Authorized Contact | GREGG R KOLEBUCK Dentist / Owner 702-838-5400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NV 3337) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2019-03-19 |