NPI | 1215638523 |
---|---|
Entity Type | Organization |
Authorized Contact | MIKE GOLPA Owner Dentist 702-768-7840 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist |
Additional Taxonomies | 1223G0001X Dentist, General Practice |
1223P0700X Dentist, Prosthodontics | |
Enumeration Date | 2023-03-14 |
Last Update Date | 2023-04-06 |