| NPI | 1043582810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERNESTO BARBOSA Owner 702-278-0876 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NV 6060) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NV 8361) |
| Enumeration Date | 2012-02-08 |
| Last Update Date | 2012-02-08 |