Provider Demographics
NPI:1710050638
Name:CALLAWAY-NELSON, CARI ALLISON (DDS)
Entity Type:Individual
Prefix:DR
First Name:CARI
Middle Name:ALLISON
Last Name:CALLAWAY-NELSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7135 S DURANGO DR
Mailing Address - Street 2:#110
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-2079
Mailing Address - Country:US
Mailing Address - Phone:240-426-5229
Mailing Address - Fax:
Practice Address - Street 1:7175 N. DURANGO DR
Practice Address - Street 2:#150
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117
Practice Address - Country:US
Practice Address - Phone:702-658-2311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4757T1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice