Provider Demographics
NPI:1144742933
Name:STEVEN V DRYDEN DDS PLLC
Entity Type:Organization
Organization Name:STEVEN V DRYDEN DDS PLLC
Other - Org Name:CARSON TAHOE ORAL AND MAXILLOFACIAL SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:VICTOR
Authorized Official - Last Name:DRYDEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:775-884-4433
Mailing Address - Street 1:1470 MEDICAL PKWY STE 260
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-4647
Mailing Address - Country:US
Mailing Address - Phone:775-884-4433
Mailing Address - Fax:775-884-4459
Practice Address - Street 1:1470 MEDICAL PKWY STE 260
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-4647
Practice Address - Country:US
Practice Address - Phone:775-884-4433
Practice Address - Fax:775-884-4459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVS2-1481223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty