Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | S3-39 | NV |
NPI | 1073635488 |
---|---|
Provider Name | Dr. William P O'gara |
First Address | Reno, NV 89511-1004 |
Second Address | Reno, NV 89511-1004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2007 |
Last Update Date | 08/07/2007 |