| NPI | 1619028800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID JAMES TRYLOVICH Owner 702-259-1943 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: NV 2707) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: NV 5103) |
| 1223P0300X Dentist, Periodontics (Licence: NV 2635) | |
| 1223P0300X Dentist, Periodontics (Licence: NV 6507) | |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2014-07-10 |