Organization
AN ELEGANT SMILE P.C.
Active
Other names
An Elegant Smile Denistry
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA VITELA (CREDENTIALING COORDINATOR)
(602) 482-7000
Entity
Organization
Contact information
Practice address
14155 N 83RD AVE BLDG 3, PEORIA, AZ 85381-5639
(623) 486-5222
(623) 486-5226
Mailing address
14155 N 83RD AVE BLDG 3, PEORIA, AZ 85381-5639
(623) 486-5222
(623) 486-5226
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3531
AZ
Other
Enumeration date
08/10/2010
Last updated
08/10/2010
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