| NPI | 1275902504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE A. KEELEY Owner/Provider 702-263-9339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2015-09-16 |
| Last Update Date | 2015-09-16 |