Organization
CPD SOUTH MEADOWS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON CHAMPAGNE DDS (OWNER)
(775) 636-9939
Entity
Organization
Contact information
Practice address
5435 KIETZKE LN STE 100, RENO, NV 89511-1088
(775) 237-2038
(775) 359-4034
Mailing address
255 GLENDALE AVE STE 3, SPARKS, NV 89431-5777
(775) 636-9939
(775) 737-4002
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
03/01/2022
Last updated
08/30/2023
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