| NPI | 1558066001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE GOLPA Owner Dentist 702-768-7840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 1223P0700X Dentist, Prosthodontics | |
| Enumeration Date | 2023-04-04 |
| Last Update Date | 2023-04-06 |