| NPI | 1992298533 |
|---|---|
| Doing Business As | DR WISDOM TEETH |
| Entity Type | Organization |
| Authorized Contact | JEFFREY FENN Owner 702-325-7627 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AZ D009399) |
| Enumeration Date | 2018-06-08 |
| Last Update Date | 2018-06-08 |