| NPI | 1386997609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MY TRAN Member 702-838-0707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NV 6131) |
| Additional Taxonomies | 122300000X Dentist (Licence: NV 5586) |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2012-10-24 |