Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 3743 | NV |
NPI | 1013928761 |
---|---|
Provider Name | Dr. Daniel I Shalev |
First Address | Henderson, NV 89074-7116 |
Second Address | Henderson, NV 89074-7116 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 08/07/2007 |