Provider Demographics
NPI:1548736721
Name:SMILE ESTHETICS SCOTTSDALE
Entity Type:Organization
Organization Name:SMILE ESTHETICS SCOTTSDALE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/DDS
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:CONANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-867-1727
Mailing Address - Street 1:11390 E VIA LINDA STE 104
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85259-4075
Mailing Address - Country:US
Mailing Address - Phone:480-867-1727
Mailing Address - Fax:480-550-6521
Practice Address - Street 1:11390 E VIA LINDA STE 104
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85259-4075
Practice Address - Country:US
Practice Address - Phone:480-867-1727
Practice Address - Fax:480-550-6521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-16
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty