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1710148663
CUSTOM SMILE LLC
MESA, AZ
NPI
1710148663
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Entity Type
Organization
Authorized Contact
STAN L COVINGTON
Dentist
480-307-8430
Organization Subpart ?
No
Primary Taxonomy
122300000X Dentist
(Licence: AZ 4675)
Enumeration Date
2008-06-23
Last Update Date
2008-07-08
Business Address
CUSTOM SMILE LLC
2919 S ELLSWORTH RD SUITE 141
MESA, AZ 85212-2164
Phone number: 480-307-8430
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Mailing Address
CUSTOM SMILE LLC
2919 S ELLSWORTH RD SUITE 141
MESA, AZ 85212-2164
Phone number: 480-307-8430
Copy
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