Ruby Mountain Dental LLC

Organization Active NPI General Practice Dentistry · Wells, NV

NPI 1700367190 · NPPES record last updated Aug 24, 2018

Key facts

NPI
1700367190
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
License
GR6862TA (NV)
Legal business name
RUBY MOUNTAIN DENTAL LLC
Practice address
1000 Humboldt Ave Ste a
Wells, NV 89835
Phone
(775) 752-3056
NPI assigned
Aug 24, 2018
Organization subpart
No

Authorized official

Name
Dr. Travis Trent Shepherd, DMD
Title
Dentist/Owner
Phone
(775) 752-3056

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X GR6862TA NV Yes

Addresses

Primary practice location

1000 Humboldt Ave Ste a
Wells, NV 89835

Mailing address

610 Garnet Dr
Kimberly, ID 83341-1942
Phone (505) 787-0082

Other providers in Wells, NV

All providers in Wells, NV · General Practice Dentistry in Nevada

Sources for this page

Verify at the official NPI Registry.