Healthcare Provider Details

I. General information

NPI: 1457474496
Provider Name (Legal Business Name): LLOYD B. AUSTIN DDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 I ST
SPARKS NV
89431-3608
US

IV. Provider business mailing address

850 I ST
SPARKS NV
89431-3608
US

V. Phone/Fax

Practice location:
  • Phone: 775-358-5330
  • Fax: 775-358-5344
Mailing address:
  • Phone: 775-358-5330
  • Fax: 775-358-5344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number394
License Number StateNV

VIII. Authorized Official

Name: MR. FRANCISCO J OLIVO
Title or Position: FINANCIAL DIRECTOR
Credential:
Phone: 775-358-5330