| NPI | 1255161097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZACHARY SOARD Owner 702-742-5824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2024-08-06 |
| Last Update Date | 2024-08-06 |