| NPI | 1639576804 |
|---|---|
| Other Name | DENTALVILLE EASTERN |
| Entity Type | Organization |
| Authorized Contact | LINDY MICHELLE ROMERO Manager 702-997-7707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2014-12-03 |
| Last Update Date | 2014-12-03 |