Dr. Marlowe Anthony San Juan Rillera, DMD
Dentist, General Practice in Las Vegas, NV. Individual provider (NPI-1).
NPI number1417366261
StatusActive
Last updated in NPPESJul 7, 2020
Details
- NPI
- 1417366261
- Entity type
- Individual (NPI-1)
- Name
- Dr. Marlowe Anthony San Juan Rillera
- Credential
- DMD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 6, 2014
- Certification date
- Jul 7, 2020
- Last updated
- Jul 7, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 7352 | NV | Yes |
| 122300000X | Dentist | 30249 | TX |
Practice location
2625 S Rainbow Blvd Ste D103Las Vegas, NV 89146-5181
Phone 702-365-1743
Mailing address
2625 S Rainbow Blvd Ste D103Las Vegas, NV 89146-5181
Phone 702-365-1743
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