Provider Demographics
NPI:1356701296
Name:PERFECT 32 DENTAL CARE LLC
Entity type:Organization
Organization Name:PERFECT 32 DENTAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HIJAZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-486-5107
Mailing Address - Street 1:2810 W CHARLESTON BLVD
Mailing Address - Street 2:STE F56
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-1921
Mailing Address - Country:US
Mailing Address - Phone:702-486-5107
Mailing Address - Fax:702-486-6254
Practice Address - Street 1:2810 W CHARLESTON BLVD
Practice Address - Street 2:STE F56
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1921
Practice Address - Country:US
Practice Address - Phone:702-486-5107
Practice Address - Fax:702-486-6254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-04
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6551122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty