Callaway-Nelson Centennial Modern Dentistry, PC
Dentist in Las Vegas, NV. Organization (NPI-2).
NPI number1982158150
StatusActive
Last updated in NPPESAug 5, 2016
Details
- NPI
- 1982158150
- Entity type
- Organization (NPI-2)
- Legal business name
- Callaway-Nelson Centennial Modern Dentistry, PC
- Organization subpart
- No
- Enumeration date
- Aug 5, 2016
- Last updated
- Aug 5, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | – | – | Yes |
Other names
- Centennial Modern Dentistry And Orthodontics (Doing Business As)
Practice location
7910 W Tropical Pkwy140
Las Vegas, NV 89149-4554
Phone 702-273-3676 · Fax 702-430-6427
Mailing address
17000 Red Hill AveIrvine, CA 92614-5626
Phone 714-845-8890 · Fax 949-474-1495
Authorized official
Cari A Callaway-Nelson
Owner
7022733676
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