| NPI | 1205284247 |
|---|---|
| Doing Business As | WISDOM TEETH GUYS |
| Entity Type | Organization |
| Authorized Contact | RYAN JOHNSON Managing Member 702-299-5821 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: TX 22989) |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2016-06-01 |