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General NPI Number Information
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NPI Number | 1528598679
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Entity Type | Organization
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Legal Business Name | THE DENTISTS' OFFICE FERNLEY LLC
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Dates
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Enumeration Date | 06/12/2017
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Last Update Date | 07/06/2023
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Provider Practice Location Address
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Address Line | 90 FALCON DR STE 110
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City | FERNLEY
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State | NV
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Zip | 89408-4729
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Country | US
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Telephone | 775-336-1510
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Fax |
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Provider Business Mailing Address
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Address Line | 3605 GRANT DRIVE
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City | RENO
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State | NV
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Zip | 89509
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Country | US
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Telephone | 775-336-1510
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Fax | 775-823-5218
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Authorized Official
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Title or Position | CFO
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Name | NATE ROCKWELL
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Credential |
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Telephone | 775-336-1510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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