| NPI | 1003198417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GILBERTO SUAREZ Owner 702-877-9977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2011-09-12 |
| Last Update Date | 2023-02-08 |