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Organization
ASHWAQ DENTAL ONE, LLC
Active
Organization
ASHWAQ DENTAL ONE, LLC
Active
Other names
Smiles of Anthem Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
ISAIMA KAYAT (MANAGER)
(602) 317-3890
Entity
Organization
Contact information
Practice address
42104 N VENTURE DR STE B118, ANTHEM, AZ 85086-3828
(623) 742-6800
(844) 273-1202
Mailing address
PO BOX 5279, PEORIA, AZ 85385-5279
16023173890
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
05/20/2017
Last updated
05/20/2017
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