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Organization
GUSSOW DENTAL CARE PROF CORP
Active
Organization
GUSSOW DENTAL CARE PROF CORP
Active
Other names
Vegas Smiles
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN WELCH DMD (MANAGING MEMBER)
(702) 371-0221
Entity
Organization
Contact information
Practice address
4343 N RANCHO DR STE 131, LAS VEGAS, NV 89130-3422
(702) 395-7200
Mailing address
10420 S DECATUR BLVD STE 110, LAS VEGAS, NV 89141-8718
(702) 371-0221
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
NULL
Other
Enumeration date
11/16/2023
Last updated
02/14/2025
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