Provider Demographics
NPI:1447499173
Name:VIRTUOSO, ARMAND G
Entity type:Individual
Prefix:
First Name:ARMAND
Middle Name:G
Last Name:VIRTUOSO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2202 W CHARLESTON BLVD
Mailing Address - Street 2:#10
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-2232
Mailing Address - Country:US
Mailing Address - Phone:702-889-1381
Mailing Address - Fax:702-823-5980
Practice Address - Street 1:2202 W CHARLESTON BLVD
Practice Address - Street 2:#10
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-2232
Practice Address - Country:US
Practice Address - Phone:702-889-1381
Practice Address - Fax:702-823-5980
Is Sole Proprietor?:No
Enumeration Date:2009-02-19
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV58011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice