| Full Name | |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 3605 Grant Dr, Reno, Nevada |
| Authorized Official Name and Position | Nate Rockwell (CFO) |
| Authorized Official Contact | 7753361510 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3605 Grant Dr Reno NV 89509-5301 Ph: (775) 825-4804 | 3605 Grant Dr Reno NV 89509-5301 Ph: (775) 825-4804 |
| NPI Number | 1235542820 |
|---|---|
| Provider Enumeration Date | 06/11/2014 |
| Last Update Date | 06/11/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235542820 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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