| NPI | 1730894312 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLAIR THOMAS Owner/ Oral Maxillofacial Surgeon 702-743-9996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Enumeration Date | 2023-01-18 |
| Last Update Date | 2023-01-18 |