| Boca Dental Premier | |
|
2018 Lake Tahoe Blvd South Lake Tahoe CA 96150-6402 | |
| (702) 703-1590 | |
| Not Available |
| Full Name | Boca Dental Premier |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2018 Lake Tahoe Blvd, South Lake Tahoe, California |
| Authorized Official Name and Position | Mary Wilcox (DIRECTOR OF BILLING) |
| Authorized Official Contact | 7027031590 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boca Dental Premier 8989 W Flamingo Rd Las Vegas NV 89147-0431 Ph: (702) 703-1590 | Boca Dental Premier 2018 Lake Tahoe Blvd South Lake Tahoe CA 96150-6402 Ph: (702) 703-1590 |
| NPI Number | 1306721931 |
|---|---|
| Provider Enumeration Date | 08/11/2025 |
| Last Update Date | 09/05/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306721931 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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