# AESTHETIC SMILES OF QUEEN CREEK

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013793785
- **Authorized official:** DR. CAMERON WEAVER BLYTH DMD (DENTIST)
- **Authorized official phone:** (480) 652-5797

## Contact information

- **Practice address:** 22362 E. DOMINGO RD. SUITE 102, QUEEN CREEK, AZ 85142
- **Practice address phone:** (480) 652-5797
- **Mailing address:** 19106 E MARY ANN WAY, QUEEN CREEK, AZ 85142-9911

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | — |
| 1223G0001X | General Practice Dentistry | — | — | — |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/07/2023
- **Last updated:** 09/07/2023