Radiant Smiles Series 5 LLC

NPI #1568778645 in Las Vegas, Nevada

Provider Information

NPI Number: 1568778645
Entity Type: Organization
Organization Name: Radiant Smiles Series 5 LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Aug 26, 2010
Last Updated: Aug 26, 2010

Practice Location

Address: 7469 W LAKE MEAD BLVD
Address 2: STE 270
City: Las Vegas
State: Nevada
ZIP Code: 89128-1030
Phone: (702) 312-8722

Authorized Official

Name: MR. DAVID C GONZALEZ
Title: DIRECTOR
Phone: (702) 312-8722

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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