Organization
BIG SMILES ARIZONA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS DEENA CHIRIAC (CREDENTIALING)
(800) 409-2563
Entity
Organization
Contact information
Practice address
1904 W PARKSIDE LN, SUITE 201, PHOENIX, AZ 85027-1228
(800) 409-2563
(623) 321-6268
Mailing address
1904 W PARKSIDE LN, SUITE 201, PHOENIX, AZ 85027-1228
(800) 409-2563
(623) 321-6268
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7705
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760508535
—
CA
Enumeration date
04/21/2009
Last updated
04/21/2009
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