Provider Demographics
NPI:1720327208
Name:P3 DENTAL - WELEBIR PC
Entity Type:Organization
Organization Name:P3 DENTAL - WELEBIR PC
Other - Org Name:PERFECT SMILE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:BEATRIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-578-6591
Mailing Address - Street 1:P3 DENTAL - WELBIR PC
Mailing Address - Street 2:1131 S. CASINO BLVD
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8965 S. EASTERN AVENUE, SUITE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123
Practice Address - Country:US
Practice Address - Phone:702-387-6453
Practice Address - Fax:702-617-6019
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:P3 DENTAL - WELEBIR PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-02-04
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty