| NPI | 1023158375 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY P. REARDON President 702-260-8241 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NV 64270) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2020-08-22 |