| NPI | 1568778645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID C GONZALEZ Director 702-312-8722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NV 4725) |
| Enumeration Date | 2010-08-26 |
| Last Update Date | 2010-08-26 |