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Organization
ELEGANT SMILES DENTISTRY
Active
Organization
ELEGANT SMILES DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALI KHAKSARFARD DDS (DENTIST/OWNER)
(614) 824-5454
Entity
Organization
Contact information
Practice address
4775 KNIGHTS BRIDGE BLVD., COLUMBUS, OH 43214
(614) 824-5454
Mailing address
4775 KNIGHTS BRIDGE BLVD., COLUMBUS, OH 43214
(614) 824-5454
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
21821
OH
Other
Enumeration date
06/19/2013
Last updated
06/19/2013
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