Provider Demographics
NPI:1639281777
Name:PERFECT SMILE DENTAL
Entity Type:Organization
Organization Name:PERFECT SMILE DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:TOURAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:HABASHI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:702-387-6453
Mailing Address - Street 1:9895 S MARYLAND PARKWAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89183
Mailing Address - Country:US
Mailing Address - Phone:702-387-6453
Mailing Address - Fax:702-617-6019
Practice Address - Street 1:9895 S MARYLAND PARKWAY
Practice Address - Street 2:SUITE A
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89183
Practice Address - Country:US
Practice Address - Phone:702-387-6453
Practice Address - Fax:702-617-6019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3051122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty