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Organization
SMILE ENVY FAMILY DENTISTRY, L.L.C.
Active
Organization
SMILE ENVY FAMILY DENTISTRY, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIEDRA A IVEY (OFFICE MANAGER)
(623) 825-3689
Entity
Organization
Contact information
Practice address
10144 W LAKE PLEASANT PKWY, SUITE 1100, PEORIA, AZ 85382-9716
(623) 825-3689
(623) 825-3695
Mailing address
10144 W LAKE PLEASANT PKWY, SUITE 1100, PEORIA, AZ 85382-9716
(623) 825-3689
(623) 825-3695
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/03/2009
Last updated
08/03/2009
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