| NPI | 1538710348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE DYAN JONES Administrator 702-260-8241 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2019-09-23 |
| Last Update Date | 2019-09-23 |