| NPI | 1720293913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYDIA CLAIRE WYATT Owner 702-220-9555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NV 4340) |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2020-08-22 |