Organization
CENTER FOR DENTAL AESTHETICS PLLC
Active
Other names
Vegas Smile Suite
Organization subpart
No
Provider details
NPI number
Authorized official
VICENTA REYES (CREDENTIALING MANAGER)
(972) 869-3789
Entity
Organization
Contact information
Practice address
7160 RAFAEL RIVERA WAY STE 130, LAS VEGAS, NV 89113-5394
(702) 357-4111
(702) 924-4857
Mailing address
7160 RAFAEL RIVERA WAY STE 130, LAS VEGAS, NV 89113-5394
(702) 357-4111
(702) 924-4857
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/16/2022
Last updated
12/20/2022
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