# BELLA VIDA DENTAL LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Bella Vita Dental LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316633001
- **Authorized official:** CLARA D PROFFITT DENTAL CONSULTANT (OWNER)
- **Authorized official phone:** (480) 370-3365

## Contact information

- **Practice address:** 4625 N ORACLE RD, TUCSON, AZ 85705-1639
- **Practice address phone:** (480) 370-3365
- **Mailing address:** PO BOX 77360, TUCSON, AZ 85703-7360
- **Mailing address phone:** (480) 370-3365

## Taxonomy

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

## Other

- **Enumeration date:** 04/14/2023
- **Last updated:** 04/18/2023