Organization
CARSON CITY PEDIATRIC DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN OLSON D.M.D. (MANAGER)
(775) 461-3800
Entity
Organization
Contact information
Practice address
4530 S CARSON ST STE 5, CARSON CITY, NV 89701-6914
(702) 308-6556
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
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
02/28/2011
Last updated
09/16/2011
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