Manuel, Renalie

Manuel, Renalie is an sole proprietor health care provider with primary practice located at 169 N Nellis Blvd , Las Vegas NV 89110-5320. She recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Pediatric Dentistry. Dental Providers / Pediatric Dentistry is her primary health care specialty. Manuel, Renalie can be contacted via phone (702) 384-1010.

Contact Information

Primary practice address
169 N Nellis Blvd Las Vegas NV 89110-5320
Fax: (702) 438-8424
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 55087 California
Dental Providers / General Practice 1223G0001X 5176 Nevada
Dental Providers / Pediatric Dentistry 1223P0221X 5176 Nevada
Dental Providers / Pediatric Dentistry 1223P0221X S6-108 Nevada

Profile Details

NPI number 1902952070
LBN Legal business name Manuel, Renalie
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 25th, 2007
Last updated Jun 27th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902952070 NPPES
Nevada MEDICAID 1902952070

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