| NPI | 1093538316 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD BAGGALEY President 702-496-6777 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry |
| Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2024-11-05 |
| Last Update Date | 2024-11-05 |