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525 E Moana Ln Ste A Reno NV 89502-4671 | |
| (775) 823-5100 | |
| (775) 823-5101 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 525 E Moana Ln, Reno, Nevada |
| Authorized Official Name and Position | Bradley R Peterson (PC OWNER/PRESIDENT) |
| Authorized Official Contact | 3608697645 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1101 Se Tech Center Dr Ste 195 Vancouver WA 98683-5511 Ph: (360) 869-7645 | 525 E Moana Ln Ste A Reno NV 89502-4671 Ph: (775) 823-5100 |
| NPI Number | 1417164765 |
|---|---|
| Provider Enumeration Date | 05/17/2007 |
| Last Update Date | 02/07/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417164765 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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