| NPI | 1285026005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEDEDIAH FELLER Manager 702-436-0999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NV s4343) |
| Enumeration Date | 2015-03-03 |
| Last Update Date | 2015-03-03 |