| NPI | 1750637096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICK J RAWSON Owner 775-853-9696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: NV S295C) |
| Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: NV 6268) |
| Enumeration Date | 2012-07-24 |
| Last Update Date | 2012-07-24 |