Organization
ASHWAQ DENTAL ONE, LLC
Active
Other names
Smiles of Anthem Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
ISAIMA KAYAT (MANAGER)
(602) 317-3890
Entity
Organization
Contact information
Practice address
42104 N VENTURE DR STE B118, ANTHEM, AZ 85086-3828
(623) 742-6800
(844) 273-1202
Mailing address
PO BOX 5279, PEORIA, AZ 85385-5279
16023173890
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/20/2017
Last updated
05/20/2017
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