Provider Demographics
NPI:1164577748
Name:NICK FURCHNER DDS LTD
Entity Type:Organization
Organization Name:NICK FURCHNER DDS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:ELLIS
Authorized Official - Last Name:FURCHNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-322-4778
Mailing Address - Street 1:605 SIERRA ROSE DR #5
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511
Mailing Address - Country:US
Mailing Address - Phone:775-322-4778
Mailing Address - Fax:775-322-7963
Practice Address - Street 1:605 SIERRA ROSE DR #5
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511
Practice Address - Country:US
Practice Address - Phone:775-322-4778
Practice Address - Fax:775-322-7963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2302122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty