Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant |
NPI | 1295375939 |
---|---|
Provider Name | Melissa Teston |
First Address | Reno, NV 89511-1004 |
Second Address | Reno, NV 89511-1004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2020 |
Last Update Date | 10/01/2020 |