Organization
RADIANT SMILES SERIES 5 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID C GONZALEZ (DIRECTOR)
(702) 312-8722
Entity
Organization
Contact information
Practice address
7469 W LAKE MEAD BLVD, STE 270, LAS VEGAS, NV 89128-1030
(702) 312-8722
(702) 312-7779
Mailing address
7469 W LAKE MEAD BLVD, STE 270, LAS VEGAS, NV 89128-1030
(702) 312-8722
(702) 312-7779
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4725
NV
Other
Enumeration date
08/26/2010
Last updated
08/26/2010
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