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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 (CREDENTIALING COORDINATOR)
(602) 482-7000
Entity
Organization
Contact information
Practice address
1360 W IRVINGTON RD STE 180, TUCSON, AZ 85746-4110
(520) 206-0030
(520) 889-0750
Mailing address
1360 W IRVINGTON RD STE 180, TUCSON, AZ 85746-4110
(520) 206-0030
(520) 889-0750
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7699
AZ
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
3317
AZ
Other
Enumeration date
06/15/2010
Last updated
09/15/2010
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