| NPI | 1881136646 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAWAN GAUTAM Orthodontist 702-489-5237 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NV S3-245C) |
| Enumeration Date | 2016-11-10 |
| Last Update Date | 2016-11-10 |