Provider Demographics
NPI:1366691339
Name:HI-TECH DENTAL CARE, INC
Entity type:Organization
Organization Name:HI-TECH DENTAL CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:MAI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:702-434-9222
Mailing Address - Street 1:5965 W TROPICANA AVE STE A
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-4892
Mailing Address - Country:US
Mailing Address - Phone:702-434-9222
Mailing Address - Fax:702-434-1126
Practice Address - Street 1:5965 W TROPICANA AVE STE A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-4892
Practice Address - Country:US
Practice Address - Phone:702-434-9222
Practice Address - Fax:702-434-1126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-15
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47282122300000X
NV4981122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty