| NPI | 1609672765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS K. SIMISTER Owner 702-254-4335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2025-02-20 |
| Last Update Date | 2025-02-20 |