| NPI | 1033910567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL EVANS CEO/Owner 702-205-2623 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 292200000X Dental Laboratory |
| 126900000X Dental Laboratory Technician | |
| Enumeration Date | 2025-03-21 |
| Last Update Date | 2025-10-29 |