Provider Demographics
NPI:1518273598
Name:CORTARO SMILES AND ORTHODONTICS, LLP
Entity Type:Organization
Organization Name:CORTARO SMILES AND ORTHODONTICS, LLP
Other - Org Name:CORTARO SMILES AND ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTRACTS ADMIN
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:J
Authorized Official - Last Name:SWENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:520-744-2233
Mailing Address - Street 1:2860 MICHELLE FL 2
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-1008
Mailing Address - Country:US
Mailing Address - Phone:714-368-2077
Mailing Address - Fax:714-368-2092
Practice Address - Street 1:8250 N CORTARO RD STE 110
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85743-7304
Practice Address - Country:US
Practice Address - Phone:520-744-2233
Practice Address - Fax:520-744-5872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-27
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty