| NPI | 1467220335 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELSEY WILLMAN Office Manager 702-360-9000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2023-12-19 |
| Last Update Date | 2023-12-19 |