| NPI | 1043530736 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS RICHARD GONZALES Dentist 702-798-6684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: NV 2427) |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2010-06-04 |