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General NPI Number Information
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NPI Number | 1972496628
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Entity Type | Organization
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Legal Business Name | NYGREN DMD
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Dates
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Enumeration Date | 06/02/2025
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 320 W A ST
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City | FALLON
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State | NV
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Zip | 89406-2947
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Country | US
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Telephone | 775-342-8253
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Fax |
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Provider Business Mailing Address
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Address Line | 320 W A ST
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City | FALLON
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State | NV
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Zip | 89406-2947
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Country | US
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Telephone | 775-342-8253
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. AMY AURORA NYGREN
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Credential | D.M.D.
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Telephone | 775-342-8253
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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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