| NPI | 1891085684 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH RAZO Office Manager 702-272-1100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 1223P0221X Dentist, Pediatric Dentistry | |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2011-04-13 |