| NPI | 1326564725 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN ELDON CHAMBERLAIN Owner/Operator 702-645-5100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2017-08-17 |
| Last Update Date | 2022-07-21 |