Provider Demographics
NPI:1336313766
Name:FIRST CARE DENTAL RENO, INC
Entity Type:Organization
Organization Name:FIRST CARE DENTAL RENO, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DUONG
Authorized Official - Middle Name:
Authorized Official - Last Name:TON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:775-827-6868
Mailing Address - Street 1:75 MOUNT ROSE ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-3424
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:75 MOUNT ROSE ST
Practice Address - Street 2:SUITE A
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-3424
Practice Address - Country:US
Practice Address - Phone:775-827-6868
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV40771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty