NPI | 1629483987 |
---|---|
Entity Type | Organization |
Authorized Contact | RANDALL P BLAIR President 702-485-9804 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: ID D4550PD) |
Enumeration Date | 2014-06-25 |
Last Update Date | 2014-06-25 |