| NPI | 1679841258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENNY KOHANTEB Owner 702-435-5015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NV NV20111452524) |
| Enumeration Date | 2011-12-09 |
| Last Update Date | 2011-12-09 |