| NPI | 1548607294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY E DAVIS Managing Member 702-477-0040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NV S6-121) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NV S3-233) |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2022-05-17 |