NPI | 1063309755 |
---|---|
Doing Business As | SHADOW CREEK CHILDREN'S DENTISTRY AND ORTHODONTICS |
Entity Type | Organization |
Authorized Contact | RYAN JOLLEY Partner 702-701-2563 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
Enumeration Date | 2025-06-23 |
Last Update Date | 2025-06-23 |