| Sparks Family Dentistry Llc | |
|
340 Pyramid Way Sparks NV 89431 | |
| (775) 359-3336 | |
| (775) 359-0755 |
| Full Name | Sparks Family Dentistry Llc |
|---|---|
| Speciality | Dentist |
| Location | 340 Pyramid Way, Sparks, Nevada |
| Authorized Official Name and Position | Thomas Aj Basora (MANAGER) |
| Authorized Official Contact | 7753593337 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sparks Family Dentistry Llc 340 Pyramid Way Sparks NV 89431 Ph: (775) 359-3336 | Sparks Family Dentistry Llc 340 Pyramid Way Sparks NV 89431 Ph: (775) 359-3336 |
| NPI Number | 1336264936 |
|---|---|
| Provider Enumeration Date | 03/20/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336264936 | NPI | - | NPPES |
| 4481 | Other | NV | LIC # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 4481 (Nevada) | Primary |
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