Healthcare Provider Details

I. General information

NPI: 1871357111
Provider Name (Legal Business Name): PERFECT SMILE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2024
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

298 E ANN RD STE 101
NORTH LAS VEGAS NV
89031-2903
US

IV. Provider business mailing address

10020 SCARLET HILLS ST
LAS VEGAS NV
89141-7017
US

V. Phone/Fax

Practice location:
  • Phone: 702-936-4011
  • Fax:
Mailing address:
  • Phone: 725-244-5512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW MANAS
Title or Position: OWNER
Credential:
Phone: 725-244-5512