Provider Demographics
NPI:1790937753
Name:BELLA DENTAL LLC
Entity Type:Organization
Organization Name:BELLA DENTAL LLC
Other - Org Name:BELLA DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:RAMSEY
Authorized Official - Last Name:RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:702-452-3552
Mailing Address - Street 1:1825 S NELLIS BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-6215
Mailing Address - Country:US
Mailing Address - Phone:702-452-3552
Mailing Address - Fax:702-452-0088
Practice Address - Street 1:1825 S NELLIS BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-6215
Practice Address - Country:US
Practice Address - Phone:702-452-3552
Practice Address - Fax:702-452-0088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty