Organization
MILES OF SMILES VENTURES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERILL BANKS (OFFICE MANAGER)
(702) 639-3515
Entity
Organization
Contact information
Practice address
4040 N. MARTIN LUTHER KING, STE B., LAS VEGAS, NV 89032-3205
(702) 639-3515
(702) 639-3516
Mailing address
4040 N. MARTIN LUTHER KING, STE B., LAS VEGAS, NV 89032-3205
(702) 639-3515
(702) 639-3516
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4522T
NV
1223G0001X
General Practice Dentistry
4522T
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100502976
—
NV
05
—
100506669
—
NV
Enumeration date
07/26/2007
Last updated
03/02/2012
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