| NPI | 1467842302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY D RICHARDSON President 702-878-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NV S6-49) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NV S6-129) |
| Enumeration Date | 2015-01-30 |
| Last Update Date | 2015-01-30 |