| NPI | 1235329210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERILL BANKS Office Manager 702-639-3515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NV 4522T) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NV 4522T) |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2012-03-02 |