# RADIANT SMILES SERIES 5 LLC

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

## Provider details

- **NPI number:** 1568778645
- **Authorized official:** MR. DAVID C GONZALEZ (DIRECTOR)
- **Authorized official phone:** (702) 312-8722

## Contact information

- **Practice address:** 7469 W LAKE MEAD BLVD, STE 270, LAS VEGAS, NV 89128-1030
- **Practice address phone:** (702) 312-8722
- **Practice address fax:** (702) 312-7779
- **Mailing address:** 7469 W LAKE MEAD BLVD, STE 270, LAS VEGAS, NV 89128-1030
- **Mailing address phone:** (702) 312-8722
- **Mailing address fax:** (702) 312-7779

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 4725 | NV | Yes |

## Other

- **Enumeration date:** 08/26/2010
- **Last updated:** 08/26/2010