Organization
SMILES ON WHEELS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL EVANS (CEO/OWNER)
(702) 205-2623
Entity
Organization
Contact information
Practice address
2701 FREDERICK ST, SHREVEPORT, LA 71109-3607
(702) 205-2623
Mailing address
11731 EMERALD LAKE AVE, LAS VEGAS, NV 89138-6403
(702) 205-2623
Taxonomy
Speciality
Code
Description
License number
State
126900000X
Dental Laboratory Technician
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
292200000X
Dental Laboratory
—
—
Other
Enumeration date
03/21/2025
Last updated
10/29/2025
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