NPI 1093919458

Mosaic Dental, Prof. Corp.

Organisation Preferred Provider Organization Las Vegas, NV

Practice location

Address: Star Brite Dental 893 S. Rainbow Blvd., Las Vegas, NV 89145
Phone: (702) 456-0034
Fax: (702) 856-0035
Mailing address: 9690 W. Tropicana Ave., Las Vegas, NV 89147

Authorised official

Name: Hai Q. Xa
Title: Doctor
Phone: (702) 456-0034

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 3780 (NV)

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Registry record

NPI: 1093919458
Entity type: Organization
NPI issued: 12 Jun 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.