Organization
COMMUNITY SMILES INITIATIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW YOUNG (DIRECTOR)
(435) 559-1247
Entity
Organization
Contact information
Practice address
10734 FENWAY PARK AVE, LAS VEGAS, NV 89166-8049
(435) 559-1247
Mailing address
10734 FENWAY PARK AVE, LAS VEGAS, NV 89166-8049
(435) 559-1247
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/28/2025
Last updated
10/28/2025
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