| NPI | 1053631309 |
|---|---|
| Doing Business As | AN ELEGANT SMILE DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | MONICA VITELA Credentialing COO Rdinator 602-482-7000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2010-06-09 |