| NPI | 1053595579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA GABLER Office Manager 702-892-0833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: NV 6502) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NV 6502) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NV 9150) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: NV 9150) | |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2023-01-23 |