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General NPI Number Information
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NPI Number | 1720538325
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Entity Type | Organization
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Legal Business Name | LITTLE SMILES LLC
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Dates
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Enumeration Date | 10/06/2016
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Last Update Date | 10/06/2016
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Provider Practice Location Address
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Address Line | 6169 S RAINBOW BLVD SUITE 100
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City | LAS VEGAS
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State | NV
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Zip | 89118-3230
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Country | US
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Telephone | 702-658-6700
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Fax | 702-450-6711
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Provider Business Mailing Address
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Address Line | 6169 S RAINBOW BLVD SUITE 100
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City | LAS VEGAS
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State | NV
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Zip | 89118-3230
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Country | US
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Telephone | 702-658-6700
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Fax | 702-450-6711
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Authorized Official
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Title or Position | MANAGER
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Name | DR. CARLA LALANDE
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Credential | DMD, MSD
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Telephone | 702-254-8858
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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 | 5876
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | S6-89
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | S6-129
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License Number State | NV
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