Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 7202 | NV |
N | 1223G0001X | General Practice | 7202 | NV |
N | 213EG0000X | General Practice | 7202 | NV |
NPI | 1003472283 |
---|---|
Provider Name | Milan Montero |
First Address | Henderson, NV 89074-0699 |
Second Address | Las Vegas, NV 89123-6702 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2019 |
Last Update Date | 14/04/2020 |