| NPI | 1154637890 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND FABIAN CORDERO Director 702-368-0911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NV 4725) |
| Enumeration Date | 2010-08-19 |
| Last Update Date | 2010-08-19 |