| NPI | 1730817487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE TERRY Financial Coordinator 702-236-9676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-08-10 |
| Last Update Date | 2022-08-10 |