Organization
AN ELEGANT SMILE P.C.
Active
Other names
An Elegant Smile Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA VITELA (CREDENTIAL COORDINATOR)
(602) 482-7000
Entity
Organization
Contact information
Practice address
4550 E BELL RD STE 8-178, PHOENIX, AZ 85032-9306
(602) 494-3000
(602) 494-3005
Mailing address
4550 E BELL RD STE 8-178, PHOENIX, AZ 85032
(602) 494-3000
(602) 494-3005
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
02/17/2009
Last updated
02/17/2009
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