| NPI | 1538298534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID MOORE Owner 702-254-6700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NV 3364) |
| Additional Taxonomies | 122300000X Dentist (Licence: NV 966) |
| 122300000X Dentist (Licence: NV 3216) | |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2020-08-22 |