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7520 Longley Ln Ste 104 Reno NV 89511-9811 | |
| (617) 470-4406 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 7520 Longley Ln Ste 104, Reno, Nevada |
| Authorized Official Name and Position | Ah Young Kim (OWNER) |
| Authorized Official Contact | 6174704406 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
255 N Sierra St Unit 515 Reno NV 89501-1378 Ph: (617) 470-4406 | 7520 Longley Ln Ste 104 Reno NV 89511-9811 Ph: (617) 470-4406 |
| NPI Number | 1073967543 |
|---|---|
| Provider Enumeration Date | 04/20/2016 |
| Last Update Date | 04/20/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073967543 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 5935 (Nevada) | Primary |
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