Organization
JASON CHAMPAGNE V, LLC
Active
Other names
Champagne Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARIANN ELAINE CHAMPAGNE DDS (OWNER)
(775) 359-3934
Entity
Organization
Contact information
Practice address
1125 AVENUE OF THE OAKS UNIT 161, SPARKS, NV 89431-4913
(775) 335-3199
(775) 870-1632
Mailing address
PO BOX 2070, SPARKS, NV 89432-2070
(775) 359-3934
(775) 359-4034
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
4049
NV
Other
Enumeration date
10/30/2014
Last updated
08/09/2024
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