Provider Demographics
NPI:1124566484
Name:TERRAVITA SMILES, PC
Entity Type:Organization
Organization Name:TERRAVITA SMILES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GOLINAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:ASADI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-250-4043
Mailing Address - Street 1:34522 N SCOTTSDALE RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85266-1224
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:34522 N SCOTTSDALE RD
Practice Address - Street 2:SUITE 140
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85266-1224
Practice Address - Country:US
Practice Address - Phone:480-250-4043
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-07
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty