Provider Demographics
NPI:1154914224
Name:DENTLER, MAUREEN (PHARMD)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:DENTLER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:MAUREEN
Other - Middle Name:
Other - Last Name:HOREJS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:8116 LAS VEGAS BLVD S
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-1015
Mailing Address - Country:US
Mailing Address - Phone:702-407-7063
Mailing Address - Fax:
Practice Address - Street 1:8116 LAS VEGAS BLVD S
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-1015
Practice Address - Country:US
Practice Address - Phone:702-407-7063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP443933183500000X
NV19454183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist