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Organization
RADIANT SMILES SERIES 4 LLC
Active
Organization
RADIANT SMILES SERIES 4 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMOND FABIAN CORDERO (DIRECTOR)
(702) 368-0911
Entity
Organization
Contact information
Practice address
4510 S EASTERN AVE STE 2, LAS VEGAS, NV 89119-6118
(702) 368-0911
(702) 734-6884
Mailing address
4510 S EASTERN AVE STE 2, LAS VEGAS, NV 89119-6118
(702) 368-0911
(702) 734-6884
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4725
NV
Other
Enumeration date
08/19/2010
Last updated
08/19/2010
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