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Organization
AN ELEGANT SMILE P.C.
Active
Organization
AN ELEGANT SMILE P.C.
Active
Other names
An Elegant Smile Denistry
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA VITELA (CREDENTIALING COORDINATOR)
(602) 482-7000
Entity
Organization
Contact information
Practice address
14155 N 83RD AVE BLDG 3, PEORIA, AZ 85381-5639
(623) 486-5222
(623) 486-5226
Mailing address
14155 N 83RD AVE BLDG 3, PEORIA, AZ 85381-5639
(623) 486-5222
(623) 486-5226
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3531
AZ
Other
Enumeration date
08/10/2010
Last updated
08/10/2010
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