| NPI | 1275221418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE FALK Managing Member 702-660-5574 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0004X Dentist, Dentist Anesthesiologist Speciality |
| Enumeration Date | 2023-04-26 |
| Last Update Date | 2023-04-26 |