| NPI | 1285873125 |
|---|---|
| Doing Business As | AN ELEGANT SMILE DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | MONICA VITELA Credential Coordinator 602-482-7000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2009-02-17 |
| Last Update Date | 2009-02-17 |