| NPI | 1891951224 |
|---|---|
| Doing Business As | FENWAY DENTAL |
| Entity Type | Organization |
| Authorized Contact | ROLAND PISCHINGER Insurance Department Manager 702-522-2028 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2008-08-05 |
| Last Update Date | 2018-05-31 |