| NPI | 1336754456 |
|---|---|
| Doing Business As | MOUNTAIN STREAM DENTAL |
| Entity Type | Organization |
| Authorized Contact | JONATHAN WELCH Member 702-371-0221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2020-09-15 |
| Last Update Date | 2020-09-15 |