Organization
AN ELEGANT SMILE P.C.
Active
Other names
An Elegant Smile Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA VITELA (CREDENTIALING COORDINATOR)
(602) 482-7000
Entity
Organization
Contact information
Practice address
1360 W IRVINGTON RD STE 180, TUCSON, AZ 85746-4110
(520) 206-0030
(520) 889-0750
Mailing address
1360 W IRVINGTON RD STE 180, TUCSON, AZ 85746-4110
(520) 206-0030
(520) 889-0750
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7699
AZ
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
3317
AZ
Other
Enumeration date
06/15/2010
Last updated
09/15/2010
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