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General NPI Number Information
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NPI Number | 1407135544
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Entity Type | Organization
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Legal Business Name | I.SMILE DENTAL INC
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Dates
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Enumeration Date | 08/08/2011
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Last Update Date | 08/08/2011
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Provider Practice Location Address
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Address Line | 7300 ARROYO CROSSING PKWY 100
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City | LAS VEGAS
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State | NV
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Zip | 89113-4072
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Country | US
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Telephone | 702-880-4266
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Fax | 702-792-4266
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Provider Business Mailing Address
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Address Line | 7300 ARROYO CROSSING PKWY 100
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City | LAS VEGAS
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State | NV
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Zip | 89113-4072
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Country | US
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Telephone | 702-880-4266
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Fax | 702-792-4266
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KENNETH T LE
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Credential | DDS
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Telephone | 702-880-4266
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 4586
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License Number State | NV
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