| NPI | 1750810552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD LINDSEY DALLEY President 702-682-5415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: NV 2368) |
| Additional Taxonomies | 122300000X Dentist (Licence: NV 2368) |
| Enumeration Date | 2017-06-06 |
| Last Update Date | 2017-06-06 |