Provider Demographics
NPI:1023103736
Name:PRESTON, PEGGY D (DDS)
Entity type:Individual
Prefix:DR
First Name:PEGGY
Middle Name:D
Last Name:PRESTON
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 1:3502 S VIRGINIA ST
Mailing Address - Street 2:SUITE A4
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-6038
Mailing Address - Country:US
Mailing Address - Phone:775-827-8808
Mailing Address - Fax:775-827-9297
Practice Address - Street 1:3502 S VIRGINIA ST
Practice Address - Street 2:SUITE A4
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-6038
Practice Address - Country:US
Practice Address - Phone:775-827-8808
Practice Address - Fax:775-827-9297
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice