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NPI Code Detail

MEDICARE: SMILES TODAY DENTAL GROUP,LLC

MEDICARE: SMILES TODAY DENTAL GROUP,LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry4647NV

General Provider Information

NPI Number : 1710358965
Entity Type Code : Organization
Provider Name (Legal Business Name) : SMILES TODAY DENTAL GROUP,LLC
Provider Business Mailing Address
First Line : 1580 E DESERT INN RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89169-2548
Country : US
Telephone Number : 702-655-6777
Fax Number : 702-547-3522
Provider Business Practice Location Address
First Line : 3225 S RAINBOW BLVD
Second Line : SUITE 104
City : LAS VEGAS
State : NV
Zip : 89146-6239
Country : US
Telephone Number : 702-655-6777
Fax Number : 702-547-3522
Authorized Official
Title or Position : DENTIST/OWNER
Name : DR. AMMAR KERIO
Credential : DMD
Telephone Number : 702-655-6777
Provider Enumeration Date : 10/14/2015
Last Update Date : 10/14/2015

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Directions to “SMILES TODAY DENTAL GROUP,LLC ” Practice Location

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