NPI | 1043573553 |
---|---|
Entity Type | Organization |
Authorized Contact | BRENDAN G JOHNSON President 702-360-8918 |
Organization Subpart ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NV S228) |
Enumeration Date | 2012-06-19 |
Last Update Date | 2012-06-19 |