| NPI | 1861400079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT ALLEN MADSEN Dentist/Owner 702-243-8788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NV 4098) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2020-08-22 |