| NPI | 1528469087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ANNE CUNDARI Business Manager 702-947-7700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NV S350) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NV S622) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NV S6-113C) | |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2014-09-15 |