I give this place 4+ stars based on their pizza and rice balls that they serve- I was missing the Italian food back home and Montesano's did a great job filling that gap. I can't comment on the pasta or sandwiches but their atmosphere, pizzas, and pastry are great.
Pluses: Pizza cheese and toppings were all excellent, pizza prep was excellent, in sum this is probably the best pizza one will find in Vegas. Furthermore, it is difficult to find a restaurant that makes rice balls at all so having them on the menu was great
Reasons to reserve the 5th star: pizza crust lacks a lot of flavor, waitress doubted that I could eat a 14" pizza, pizza not extremely tasty when cold, rice balls not as good as grandma's (a selection of different fillings might be nice), price of pizza too high (~$12 for a basic cheese)