An Elegant Smile P.c.

NPI #1053631309 in Mesa, Arizona

Provider Information

NPI Number: 1053631309
Entity Type: Organization
Organization Name: An Elegant Smile P.c.
Primary Specialty: Dentist - General Practice
Enumeration Date: Jun 9, 2010
Last Updated: Jun 9, 2010

Practice Location

Address: 1425 S GREENFIELD RD
Address 2: BLDG 2 STE 110
City: Mesa
State: Arizona
ZIP Code: 85206-5529
Phone: (480) 854-3434

Authorized Official

Name: MONICA VITELA
Title: CREDENTIALING COORDINATOR
Phone: (602) 482-7000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery	1223S0112X
Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics	1223X0400X
Dentist - General Practice — General Practice	1223G0001X	Primary

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