Organization
CFD SOUTH MEADOWS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON CHAMPAGNE (OWNER)
(775) 636-9939
Entity
Organization
Contact information
Practice address
9598 PROTOTYPE CT STE A, RENO, NV 89521-3950
(775) 234-5595
Mailing address
PO BOX 2070, SPARKS, NV 89432-2070
(775) 636-9939
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/19/2023
Last updated
08/30/2023
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