| NPI | 1861720864 |
|---|---|
| Doing Business As | MADDISON AVE DENTAL |
| Entity Type | Organization |
| Authorized Contact | MATTHEW WELEBIR Owner Dentist 702-953-2239 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2009-12-02 |
| Last Update Date | 2009-12-02 |