| NPI | 1477788271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS R GONZALES President 702-798-6684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NV 2427) |
| Enumeration Date | 2009-05-21 |
| Last Update Date | 2009-11-04 |