Basic Information
| Provider Information | |||||||||
| NPI: | 1528633286 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MAAN | ||||||||
| FirstName: | RASOOL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1820 E CRAIG RD UNIT 102 | ||||||||
| Address2: | |||||||||
| City: | NORTH LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 890303321 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7026801009 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1820 E CRAIG RD UNIT 102 | ||||||||
| Address2: | |||||||||
| City: | NORTH LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 890303321 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7026801009 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/25/2021 | ||||||||
| LastUpdateDate: | 07/14/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | 7632TU | NV | Y | Dental Providers | Dentist |
No ID Information.