| NPI | 1700770476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEANCA JHANINE MULATO SAMIANO Owner/Managing Member 702-985-7939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2025-06-05 |
| Last Update Date | 2025-06-05 |