| NPI | 1649872631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEISA TORRENS Insurance Specialist 702-360-3759 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2020-11-13 |
| Last Update Date | 2020-11-13 |