Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 5572 | NV |
NPI | 1003000167 |
---|---|
Provider Name | Dr. Julio Edgardo Escobar |
First Address | Dayton, NV 89403-7482 |
Second Address | Dayton, NV 89403-7482 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2007 |
Last Update Date | 12/05/2010 |