| NPI | 1659664662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA ALSTROM Office Manager 702-562-8852 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NV 3724) |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2011-05-24 |