Provider Demographics
NPI:1164760955
Name:SMILE4EVER LLC
Entity Type:Organization
Organization Name:SMILE4EVER LLC
Other - Org Name:SIGNATURE SMILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST / SUPERVISOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GILBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:SUAREZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:702-877-9999
Mailing Address - Street 1:4670 S FORT APACHE RD
Mailing Address - Street 2:SUITE #120
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-7939
Mailing Address - Country:US
Mailing Address - Phone:702-877-9999
Mailing Address - Fax:702-877-9977
Practice Address - Street 1:4670 S FORT APACHE RD
Practice Address - Street 2:SUITE #120
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-7939
Practice Address - Country:US
Practice Address - Phone:702-877-9999
Practice Address - Fax:702-877-9977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-29
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty