# SMILE ENVY FAMILY DENTISTRY, L.L.C.

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

## Provider details

- **NPI number:** 1194956532
- **Authorized official:** MS. DIEDRA A IVEY (OFFICE MANAGER)
- **Authorized official phone:** (623) 825-3689

## Contact information

- **Practice address:** 10144 W LAKE PLEASANT PKWY, SUITE 1100, PEORIA, AZ 85382-9716
- **Practice address phone:** (623) 825-3689
- **Practice address fax:** (623) 825-3695
- **Mailing address:** 10144 W LAKE PLEASANT PKWY, SUITE 1100, PEORIA, AZ 85382-9716
- **Mailing address phone:** (623) 825-3689
- **Mailing address fax:** (623) 825-3695

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 08/03/2009
- **Last updated:** 08/03/2009