# HENDERSON SUNRISE NIELSON PDC PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sunrise Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306664958
- **Authorized official:** MARK CHRISTENSEN (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (801) 305-3460

## Contact information

- **Practice address:** 1550 W HORIZON RIDGE PKWY STE S, HENDERSON, NV 89012-3605
- **Practice address phone:** (702) 270-8880
- **Mailing address:** 355 S 520 W STE 250, LINDON, UT 84042-1976
- **Mailing address phone:** (801) 304-3460
- **Mailing address fax:** (801) 355-6551

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 10/02/2024
- **Last updated:** 10/02/2024