Organization
SMILE PHOENIX PLLC
Active
Other names
Smile Fitness Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS GORDON D.D.S (PRESIDENT)
(623) 362-8200
Entity
Organization
Contact information
Practice address
2330 N 75TH AVE STE 112, PHOENIX, AZ 85035-1200
(623) 849-0477
(623) 849-6111
Mailing address
2330 N 75TH AVE STE 112, PHOENIX, AZ 85035-1200
(623) 849-0477
(623) 849-6111
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2191
AZ
Other
Enumeration date
10/05/2010
Last updated
10/05/2010
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