# CFD SOUTH MEADOWS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912612326
- **Authorized official:** JASON CHAMPAGNE (OWNER)
- **Authorized official phone:** (775) 636-9939

## Contact information

- **Practice address:** 9598 PROTOTYPE CT STE A, RENO, NV 89521-3950
- **Practice address phone:** (775) 234-5595
- **Mailing address:** PO BOX 2070, SPARKS, NV 89432-2070
- **Mailing address phone:** (775) 636-9939

## Taxonomy

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

## Other

- **Enumeration date:** 01/19/2023
- **Last updated:** 08/30/2023