Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | S7-68 | NV |
NPI | 1023251170 |
---|---|
Provider Name | Dr. Adam Joseph Gatan |
First Address | Las Vegas, NV 89123 |
Second Address | Las Vegas, NV 89123 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2009 |
Last Update Date | 27/02/2015 |