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Organization
NORTHERN NEVADA DENTAL SPECIALTY GROUP
Active
Organization
NORTHERN NEVADA DENTAL SPECIALTY GROUP
Active
Other names
My Kid's Smile
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICHOLAS CHANNING CHRISTIANSEN (MANAGER)
(775) 848-3005
Entity
Organization
Contact information
Practice address
3150 VISTA BLVD, SUITE 110, SPARKS, NV 89436-6712
(775) 852-6164
Mailing address
10645 DOUBLE R BLVD, RENO, NV 89521-8920
(775) 852-6164
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4489
NV
1223P0221X
Pediatric Dentistry
36-117
NV
Other
Enumeration date
06/24/2015
Last updated
06/24/2015
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