| 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 |