Provider Demographics
NPI:1164683470
Name:SILVER SPRINGS STAGECOACH HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:SILVER SPRINGS STAGECOACH HOSPITAL DISTRICT
Other - Org Name:SILVER STAGE DENTAL
Other - Org Type:Other Name
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KARI
Authorized Official - Middle Name:
Authorized Official - Last Name:LARSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-577-2700
Mailing Address - Street 1:PO BOX 567
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRINGS
Mailing Address - State:NV
Mailing Address - Zip Code:89429-0567
Mailing Address - Country:US
Mailing Address - Phone:775-577-3344
Mailing Address - Fax:775-577-3355
Practice Address - Street 1:3595 HIGHWAY 50 WEST
Practice Address - Street 2:
Practice Address - City:SILVER SPRINGS
Practice Address - State:NV
Practice Address - Zip Code:89429
Practice Address - Country:US
Practice Address - Phone:775-463-3344
Practice Address - Fax:775-463-3355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-19
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty