Provider Demographics
NPI:1821883224
Name:NICE SMILES RENO, PLLC
Entity type:Organization
Organization Name:NICE SMILES RENO, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGRUDER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:775-671-8659
Mailing Address - Street 1:1363 PETAR DR
Mailing Address - Street 2:
Mailing Address - City:GARDNERVILLE
Mailing Address - State:NV
Mailing Address - Zip Code:89410-5868
Mailing Address - Country:US
Mailing Address - Phone:775-671-8659
Mailing Address - Fax:
Practice Address - Street 1:175 BRINKBY AVE
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-4327
Practice Address - Country:US
Practice Address - Phone:775-446-7623
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Single Specialty