Organization
LITTLE SMILES PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL FREDRICK NELSON D.D.S. (DOCTOR)
(702) 658-6700
Entity
Organization
Contact information
Practice address
6169 S RAINBOW BLVD STE 100, LAS VEGAS, NV 89118-3231
(702) 658-6700
(702) 450-6711
Mailing address
6169 S RAINBOW BLVD STE 100, LAS VEGAS, NV 89118-3231
(702) 658-6700
(702) 450-6711
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
S6-47
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100511590
—
NV
01
—
1988252
UNITED CONCORDIA
NV
Enumeration date
03/13/2009
Last updated
03/11/2010
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