Took a bit to figure out so wanted to post. Thanks!
(This is with default LCD disabled btw)

Code:
# nvidia-settings: X configuration file generated by nvidia-settings
# nvidia-settings:  version 1.0  (buildmeister@builder58)  Wed Dec  9 16:35:48 PST 2009

# nvidia-xconfig: X configuration file generated by nvidia-xconfig
# nvidia-xconfig:  version 1.0  (buildmeister@builder62)  Wed May 27 01:58:49 PDT 2009

Section "ServerLayout"
    Identifier     "Layout0"
    Screen      0  "Screen0" 0 0
    InputDevice    "Keyboard0" "CoreKeyboard"
    InputDevice    "Mouse0" "CorePointer"
    InputDevice    "Synaptics Touchpad"
    Option         "Xinerama" "0"
EndSection

Section "Files"
EndSection

Section "Module"
    Load           "dbe"
    Load           "extmod"
    Load           "type1"
    Load           "freetype"
    Load           "glx"
EndSection

Section "ServerFlags"
    Option         "Xinerama" "0"
EndSection

Section "InputDevice"

    # generated from default
    Identifier     "Mouse0"
    Driver         "mouse"
    Option         "Protocol" "auto"
    Option         "Device" "/dev/psaux"
    Option         "Emulate3Buttons" "no"
    Option         "ZAxisMapping" "4 5"
EndSection

Section "InputDevice"

    # generated from default
    Identifier     "Keyboard0"
    Driver         "kbd"
EndSection

Section "InputDevice"
    Identifier     "Synaptics Touchpad"
    Driver         "synaptics"
    Option         "SendCoreEvents" "true"
    Option         "Device" "/dev/psaux"
    Option         "Protocol" "auto-dev"
    Option         "HorizEdgeScroll" "0"
    Option         "SHMConfig" "on"
EndSection

Section "Monitor"
    Identifier     "Monitor0"
    VendorName     "SE198WFP"
    ModelName      "CRT-0"
    HorizSync       30.0 - 83.0
    VertRefresh     56.0 - 75.0
    Option         "DPMS"
    Option         "DPI" "90 x 90"

    # http://support.dell.com/support/edocs/monitors/SE198WFP/en/about.htm#Specifications

    # 1440x900 @ 60.00 Hz (GTF) hsync: 55.92 kHz; pclk: 106.47 MHz
    Modeline "1440x900_60.00"  106.47  1440 1520 1672 1904  900 901 904 932  -HSync +Vsync
EndSection

Section "Device"
    Identifier     "Device0"
    Driver         "nvidia"
    VendorName     "NVIDIA Corporation"
    BoardName      "Quadro NVS 135M"
    Option         "NoLogo" "true"
EndSection

Section "Screen"

# Removed Option "metamodes" "CRT: nvidia-auto-select +0+0, DFP: nvidia-auto-select +0+0"
# Removed Option "metamodes" "CRT: 1440x900_60 +0+0, DFP: nvidia-auto-select +0+0"
    Identifier     "Screen0"
    Device         "Device0"
    Monitor        "Monitor0"
    DefaultDepth    24
    Option         "TwinView" "1"
    Option         "TwinViewXineramaInfoOrder" "CRT-0"
    Option         "metamodes" "CRT: 1440x900_60.00 +0+0, DFP: NULL"
    SubSection     "Display"
        Depth       24
    EndSubSection
EndSection