| NPI | 1215332374 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARIANN ELAINE CHAMPAGNE Owner 775-359-3934 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NV 4049) |
| Enumeration Date | 2014-10-30 |
| Last Update Date | 2014-10-30 |