# FABULOUS SMILES OF MESA

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** FABULOUS DENTAL MANAGEMENT, LLC
- **Other names:** Fabulous Smiles
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1245575398
- **Legal business name:** FABULOUS DENTAL MANAGEMENT, LLC
- **Authorized official:** DR. KEVIN HYUNG CHOI DDS (MANAGER)
- **Authorized official phone:** (480) 654-3000

## Contact information

- **Practice address:** 4434 E. BROWN RD, STE 104, MESA, AZ 85205
- **Practice address phone:** (480) 654-3000
- **Practice address fax:** (480) 654-0303
- **Mailing address:** 4434 E. BROWN RD., STE 104, MESA, AZ 85205
- **Mailing address phone:** (480) 654-3000
- **Mailing address fax:** (480) 654-0303

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 8358 | AZ | Yes |

## Other

- **Enumeration date:** 11/30/2012
- **Last updated:** 11/30/2012