# AN ELEGANT SMILE P.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** An Elegant Smile Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285873125
- **Authorized official:** MONICA VITELA (CREDENTIAL COORDINATOR)
- **Authorized official phone:** (602) 482-7000

## Contact information

- **Practice address:** 4550 E BELL RD STE 8-178, PHOENIX, AZ 85032-9306
- **Practice address phone:** (602) 494-3000
- **Practice address fax:** (602) 494-3005
- **Mailing address:** 4550 E BELL RD STE 8-178, PHOENIX, AZ 85032
- **Mailing address phone:** (602) 494-3000
- **Mailing address fax:** (602) 494-3005

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | — |

## Other

- **Enumeration date:** 02/17/2009
- **Last updated:** 02/17/2009