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NPI Code Detail

MEDICARE: DESIREE LYNN CANO

MEDICARE:   DESIREE LYNN CANO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1126800000XDental Assistant

General Provider Information

NPI Number : 1477185403
Entity Type Code : Individual
Provider Name (Legal Business Name) : DESIREE LYNN CANO
Provider Business Mailing Address
First Line : 1789 COLLEGE PKWY STE 121
Second Line :
City : CARSON CITY
State : NV
Zip : 89706-7976
Country : US
Telephone Number : 775-887-9453
Fax Number :
Provider Business Practice Location Address
First Line : 1789 COLLEGE PKWY STE 121
Second Line :
City : CARSON CITY
State : NV
Zip : 89706-7976
Country : US
Telephone Number : 775-887-9453
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2020
Last Update Date : 02/07/2020

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Directions to “ DESIREE LYNN CANO ” Practice Location

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