| NPI | 1104337401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TROY JEFFREY TROBOUGH Member 702-296-9119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NV 2947) |
| Enumeration Date | 2017-10-13 |
| Last Update Date | 2017-10-13 |