# SMILES OF BEAUTY PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417057332
- **Authorized official:** TINA DUCAS (OFFICE MANAGER)
- **Authorized official phone:** (623) 551-6300

## Contact information

- **Practice address:** 42104 N VENTURE DR, SUITE B134, ANTHEM, AZ 85086
- **Practice address phone:** (623) 551-6300
- **Practice address fax:** (623) 551-6302
- **Mailing address:** 42104 N VENTURE DR, SUITE B134, ANTHEM, AZ 85086
- **Mailing address phone:** (623) 551-6300
- **Mailing address fax:** (623) 551-6302

## Taxonomy

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

## Other

- **Enumeration date:** 09/22/2006
- **Last updated:** 08/22/2020