| NPI | 1114454097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATE ROCKWELL Manager 775-336-1510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2017-05-22 |
| Last Update Date | 2018-03-17 |