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
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
11/16/2023
Last updated
02/14/2025
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