| NPI | 1346647757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF EDWARD MOXLEY President 702-898-8350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2014-12-01 |
| Last Update Date | 2014-12-01 |