| NPI | 1619243094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY NGO President 702-580-1273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 45936) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 45936) |
| Enumeration Date | 2012-03-29 |
| Last Update Date | 2012-03-29 |