Organization
FAMILT& ESTHETIC DENTISTRY
Active
Other names
Lifetime smiles
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NEDA DELAVARI DDS (GENERAL DENTIST)
(623) 878-6000
Entity
Organization
Contact information
Practice address
6666 W PEORIA AVE, GLENDALE, AZ 85302-7014
(623) 878-6000
(623) 773-2230
Mailing address
6666 W PEORIA AVE, GLENDALE, AZ 85302-7014
(623) 878-6000
(623) 773-2230
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
8667
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8667
DENTAL LICENSE
AZ
Enumeration date
01/07/2016
Last updated
01/07/2016
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