Organization
PHOENIX DENTAL PROVIDERS, INC.
Active
Other names
Smile Clinique
Organization subpart
No
Provider details
NPI number
Authorized official
MR. YOUSSEF SALLOUM (BUSINESS OWNER)
(602) 730-7012
Entity
Organization
Contact information
Practice address
6520 N 7TH AVE, SUITE 5, PHOENIX, AZ 85013-1173
(602) 730-7012
Mailing address
6520 N 7TH AVE, SUITE 5, PHOENIX, AZ 85013-1173
(602) 730-7012
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D05888
AZ
Other
Enumeration date
09/14/2015
Last updated
09/14/2015
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