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General NPI Number Information
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NPI Number | 1871357111
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Entity Type | Organization
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Legal Business Name | PERFECT SMILE LLC
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Dates
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Enumeration Date | 02/07/2024
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | 9210 S EASTERN AVE STE 130
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City | LAS VEGAS
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State | NV
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Zip | 89123-4834
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Country | US
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Telephone | 702-508-0848
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Fax |
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Provider Business Mailing Address
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Address Line | 10020 SCARLET HILLS ST
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City | LAS VEGAS
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State | NV
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Zip | 89141-7017
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Country | US
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Telephone | 725-244-5512
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MATTHEW MANAS
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Credential |
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Telephone | 725-244-5512
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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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