| NPI | 1417186511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM LEONARD STOUT Director 702-798-8405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NV 5847) |
| Enumeration Date | 2009-07-09 |
| Last Update Date | 2009-07-09 |