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NPI Code Detail

MEDICARE: RADIANT SMILES SERIES 8 LLC

MEDICARE: RADIANT SMILES SERIES 8 LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QD0000XDental Clinic/Center

General Provider Information

NPI Number : 1447047014
Entity Type Code : Organization
Provider Name (Legal Business Name) : RADIANT SMILES SERIES 8 LLC
Provider Business Mailing Address
First Line : 1680 TANGIERS DR
Second Line :
City : HENDERSON
State : NV
Zip : 89012-7236
Country : US
Telephone Number : 702-970-0512
Fax Number :
Provider Business Practice Location Address
First Line : 5095 BLUE DIAMOND RD STE 105
Second Line :
City : LAS VEGAS
State : NV
Zip : 89139-7693
Country : US
Telephone Number : 702-970-0512
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : DR. ADRIAN RUIZ
Credential :
Telephone Number : 702-970-0512
Provider Enumeration Date : 04/24/2025
Last Update Date : 04/24/2025

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Directions to “RADIANT SMILES SERIES 8 LLC ” Practice Location

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