Miles Of Smiles Ventures, Llc | |
4040 N. Martin Luther King Ste B. Las Vegas NV 89032-3205 | |
(702) 639-3515 | |
(702) 639-3516 |
Full Name | Miles Of Smiles Ventures, Llc |
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Speciality | Dentist |
Location | 4040 N. Martin Luther King, Las Vegas, Nevada |
Authorized Official Name and Position | Sherill Banks (OFFICE MANAGER) |
Authorized Official Contact | 7026393515 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Miles Of Smiles Ventures, Llc 4040 N. Martin Luther King Ste B. Las Vegas NV 89032-3205 Ph: (702) 639-3515 | Miles Of Smiles Ventures, Llc 4040 N. Martin Luther King Ste B. Las Vegas NV 89032-3205 Ph: (702) 639-3515 |
NPI Number | 1235329210 |
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Provider Enumeration Date | 07/26/2007 |
Last Update Date | 03/02/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1235329210 | NPI | - | NPPES |
100506669 | Medicaid | NV | |
100502976 | Medicaid | NV |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 4522T (Nevada) | Primary |
1223G0001X | Dentist - General Practice | 4522T (Nevada) | Secondary |
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