| NPI | 1447618244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDDIE MARTINEZ Owner 702-979-9799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NV S3-256) |
| Enumeration Date | 2016-02-08 |
| Last Update Date | 2016-02-08 |