| NPI | 1467699843 |
|---|---|
| Doing Business As | BLACK MOUNTAIN DENTAL |
| Entity Type | Organization |
| Authorized Contact | HEEYUP GHIM President 702-564-4498 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NV 4848) |
| Enumeration Date | 2009-01-07 |
| Last Update Date | 2009-01-07 |