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1100 California Ave Reno NV 89509-2553 | |
| (775) 322-4388 | |
| (775) 324-4484 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1100 California Ave, Reno, Nevada |
| Authorized Official Name and Position | John Michael Libke (PRESIDENT) |
| Authorized Official Contact | 7753224388 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1100 California Ave Reno NV 89509-2553 Ph: (775) 322-4388 | 1100 California Ave Reno NV 89509-2553 Ph: (775) 322-4388 |
| NPI Number | 1215151766 |
|---|---|
| Provider Enumeration Date | 04/13/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215151766 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 1099 (Nevada) | Primary |
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