Provider Demographics
NPI:1063546570
Name:ANGHESOM AND BUDA-GORDON, DDS, PC
Entity type:Organization
Organization Name:ANGHESOM AND BUDA-GORDON, DDS, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MERON
Authorized Official - Middle Name:
Authorized Official - Last Name:ANGHESOM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:702-939-1298
Mailing Address - Street 1:375 N STEPHANIE ST
Mailing Address - Street 2:#1511
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-8771
Mailing Address - Country:US
Mailing Address - Phone:702-939-1298
Mailing Address - Fax:702-939-1297
Practice Address - Street 1:375 N STEPHANIE ST
Practice Address - Street 2:#1511
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-8771
Practice Address - Country:US
Practice Address - Phone:702-939-1298
Practice Address - Fax:702-939-1297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty