Organization
NORTHERN NEVADA DENTAL SPECIALTIES GROUP, LLC
Active
Other names
My Kids Smile
Organization subpart
No
Provider details
NPI number
Authorized official
ALETA VALERIE BEUTER (CREDENTIALING SPECIALIST)
(775) 409-4614
Entity
Organization
Contact information
Practice address
5030 LAS BRISAS BLVD STE B-3, RENO, NV 89523-6239
(775) 852-6164
(775) 284-7352
Mailing address
3605 GRANT DR, RENO, NV 89509-5301
(775) 409-4614
(775) 376-9075
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1223P0221X
PEDIATRIC DENTISTRY
—
Enumeration date
12/12/2017
Last updated
12/12/2017
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