NPI | 1407021678 |
---|---|
Entity Type | Organization |
Authorized Contact | ERNESTO HIPOLITO Dentist 702-644-4484 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NV 4834T) |
Enumeration Date | 2008-04-28 |
Last Update Date | 2008-04-28 |