# ASHWAQ DENTAL ONE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Smiles of Anthem Family Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144757196
- **Authorized official:** ISAIMA KAYAT (MANAGER)
- **Authorized official phone:** (602) 317-3890

## Contact information

- **Practice address:** 42104 N VENTURE DR STE B118, ANTHEM, AZ 85086-3828
- **Practice address phone:** (623) 742-6800
- **Practice address fax:** (844) 273-1202
- **Mailing address:** PO BOX 5279, PEORIA, AZ 85385-5279
- **Mailing address phone:** 16023173890

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/20/2017
- **Last updated:** 05/20/2017