| NPI | 1851798581 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HALEY A MACIAS Office Manager 888-963-9601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NV S697) |
| Enumeration Date | 2014-11-24 |
| Last Update Date | 2014-11-24 |