| NPI | 1467827105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEILA KHOSSOOSI Doctor/Manager 702-522-9192 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NV 6365) |
| Additional Taxonomies | 122300000X Dentist (Licence: NV 6598) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NV S3-281) | |
| Enumeration Date | 2015-12-07 |
| Last Update Date | 2015-12-07 |