Organization
PEORIA HEALTHY SMILES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GINA MICHELLE ELROD DDS (OWNER)
(623) 974-4799
Entity
Organization
Contact information
Practice address
13660 N 94TH DR STE E3, PEORIA, AZ 85381-4209
(623) 974-4799
Mailing address
13660 N 94TH DR STE E3, PEORIA, AZ 85381-4209
(623) 974-4799
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
AZ8063
AZ
Other
Enumeration date
12/27/2013
Last updated
12/27/2013
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