| NPI | 1720592140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL GARDNER Partner 702-234-5717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2017-11-21 |
| Last Update Date | 2018-03-17 |