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Organization
AN ELEGANT SMILE P.C.
Active
Organization
AN ELEGANT SMILE P.C.
Active
Other names
An Elegant Smile Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA VITELA (CREDENTIAL COORDINATOR)
(602) 482-7000
Entity
Organization
Contact information
Practice address
4550 E BELL RD STE 8-178, PHOENIX, AZ 85032-9306
(602) 494-3000
(602) 494-3005
Mailing address
4550 E BELL RD STE 8-178, PHOENIX, AZ 85032
(602) 494-3000
(602) 494-3005
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
02/17/2009
Last updated
02/17/2009
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