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General NPI Number Information
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NPI Number | 1083408132
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Entity Type | Organization
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Legal Business Name | RADIANT SMILES SERIES 7, LLC
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Dates
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Enumeration Date | 04/05/2025
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Last Update Date | 04/05/2025
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Provider Practice Location Address
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Address Line | 6311 N DECATUR BLVD STE 140
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City | LAS VEGAS
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State | NV
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Zip | 89130-8013
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Country | US
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Telephone | 435-559-1247
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Fax |
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Provider Business Mailing Address
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Address Line | 6311 N DECATUR BLVD STE 140
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City | LAS VEGAS
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State | NV
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Zip | 89130-8013
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | REGIONAL MANAGER
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Name | MATTHEW YOUNG
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Credential |
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Telephone | 435-559-1247
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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