# SUMMIT SMILES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104331081
- **Authorized official:** ANGELA GOLDEN (MANAGEMENT CONSULTANT)
- **Authorized official phone:** (775) 846-4777

## Contact information

- **Practice address:** 10595 DOUBLE R BLVD, RENO, NV 89521-8909
- **Practice address phone:** (775) 825-8463
- **Practice address fax:** (775) 332-8466
- **Mailing address:** 10595 DOUBLE R BLVD, RENO, NV 89521-8909
- **Mailing address phone:** (775) 825-8463
- **Mailing address fax:** (775) 332-8466

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 4783 | NV | Yes |

## Other

- **Enumeration date:** 12/13/2017
- **Last updated:** 12/13/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0664 | NEVADA DENTAL BOARD OF EXAMINERS | NV |