Provider Demographics
NPI:1235145996
Name:PARADISE DENTAL LLC
Entity Type:Organization
Organization Name:PARADISE DENTAL LLC
Other - Org Name:SILVERADO FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:R. GARTH
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:702-699-5551
Mailing Address - Street 1:PARADISE DENTAL LLC DBA SILVERADO FAMILY DENTAL
Mailing Address - Street 2:9777 S. BERMUDAA RD SUITE 100
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89183
Mailing Address - Country:US
Mailing Address - Phone:702-699-5551
Mailing Address - Fax:702-914-9019
Practice Address - Street 1:PARADISE DENTAL LLC DBA SILVERADO FAMILY DENTAL
Practice Address - Street 2:9777 S. BERMUDAA RD SUITE 100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89183
Practice Address - Country:US
Practice Address - Phone:702-699-5551
Practice Address - Fax:702-914-9019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3208261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental