| NPI | 1366823973 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA SHAGHARYAN Dentist 702-858-6815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NV 6646) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: NV 6646) |
| Enumeration Date | 2015-06-10 |
| Last Update Date | 2015-06-10 |