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General NPI Number Information
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NPI Number | 1427220037
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Entity Type | Organization
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Legal Business Name | NORTHERN NEVADA DENTAL HEALTH PROGRAMS
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Dates
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Enumeration Date | 03/24/2008
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 5605 RIGGINS CT STE 101A
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City | RENO
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State | NV
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Zip | 89502-6575
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Country | US
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Telephone | 775-982-7989
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Fax | 775-337-0298
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Provider Business Mailing Address
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Address Line | 5605 RIGGINS CT STE 101A
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City | RENO
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State | NV
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Zip | 89502-6575
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Country | US
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Telephone | 775-982-7989
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Fax | 775-337-0298
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Authorized Official
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Title or Position | PRESIDENT
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Name | GREGORY J PISANI
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Credential | DDS
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Telephone | 775-337-0296
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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