NPI | 1740650118 |
---|---|
Doing Business As | GREEN VALLEY MODERN DENTISTRY |
Entity Type | Organization |
Authorized Contact | CODY P MUGLESTON Owner Dentist 702-465-8187 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist General Practice |
Enumeration Date | 2015-09-29 |
Last Update Date | 2015-09-29 |