| NPI | 1285955088 |
|---|---|
| Doing Business As | AN ELEGANT SMILE DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | MONICA VITELA Credentialing Coordinator 602-482-7000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 7699) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: AZ 3317) |
| Enumeration Date | 2010-06-15 |
| Last Update Date | 2010-09-15 |