Organization
CCPD LLC
Active
Other names
Carson City Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN OLSON DMD (MANAGER)
(775) 461-3800
Entity
Organization
Contact information
Practice address
4530 S CARSON ST STE 5, CARSON CITY, NV 89701-6914
(775) 461-3800
(775) 461-3801
Mailing address
4530 S CARSON ST STE 5, CARSON CITY, NV 89701-6914
(775) 461-3800
(775) 461-3801
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
S6-109
NV
Other
Enumeration date
12/01/2016
Last updated
12/01/2016
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