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General NPI Number Information
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NPI Number | 1295550424
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Entity Type | Organization
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Legal Business Name | JUST SMILE LLC
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Dates
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Enumeration Date | 11/21/2024
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Last Update Date | 12/01/2024
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Provider Practice Location Address
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Address Line | 2840 E FLAMINGO RD STE G
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City | LAS VEGAS
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State | NV
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Zip | 89121-5202
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Country | US
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Telephone | 725-250-2840
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Fax |
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Provider Business Mailing Address
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Address Line | 2840 E FLAMINGO RD STE G
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City | LAS VEGAS
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State | NV
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Zip | 89121-5202
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Country | US
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Telephone | 725-250-2840
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | DEREK WINN
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Credential |
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Telephone | 725-259-4332
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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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