| NPI | 1922569607 |
|---|---|
| Doing Business As | BOCA DENTAL & BRACES |
| Entity Type | Organization |
| Authorized Contact | WYATT STOTT DANNELS Owner 702-456-0005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2019-06-11 |