Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 6648 | NV |
NPI | 1083090864 |
---|---|
Provider Name | Chandler Hyer |
First Address | Las Vegas, NV 89138-7540 |
Second Address | Las Vegas, NV 89144-4271 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2015 |
Last Update Date | 02/07/2021 |