| NPI | 1225513732 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE EDWARDS Manager 702-998-7400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2018-10-01 |
| Last Update Date | 2018-10-01 |