Smiles By Delivery, PLLC
Dentist in Surprise, AZ. Organization (NPI-2).
NPI number1295083202
StatusActive
Last updated in NPPESAug 24, 2012
Details
- NPI
- 1295083202
- Entity type
- Organization (NPI-2)
- Legal business name
- Smiles By Delivery, PLLC
- Organization subpart
- No
- Enumeration date
- Aug 22, 2012
- Last updated
- Aug 24, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | – | – | Yes |
| 124Q00000X | Dental Hygienist | h04804 | AZ | |
| 124Q00000X | Dental Hygienist | h05302 | AZ |
Practice location
15508 W Bell Rd101-525
Surprise, AZ 85374-2432
Phone 623-584-4746 · Fax 623-584-4750
Mailing address
15508 W Bell Rd101-525
Surprise, AZ 85374-2432
Phone 623-584-4746 · Fax 623-584-4750
Authorized official
Elaine Carmella Mamola
Rdh/Owner
6027177757
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