Provider Demographics
NPI:1679828297
Name:TUCSON SMILES PEDIATRIC DENTISTRY AS SWAN
Entity Type:Organization
Organization Name:TUCSON SMILES PEDIATRIC DENTISTRY AS SWAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PRIYA
Authorized Official - Middle Name:YAMINI
Authorized Official - Last Name:ABRAMIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:520-544-4171
Mailing Address - Street 1:2810 N SWAN RD STE 140
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-6300
Mailing Address - Country:US
Mailing Address - Phone:520-881-2966
Mailing Address - Fax:520-881-1341
Practice Address - Street 1:2810 N SWAN RD STE 140
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-6300
Practice Address - Country:US
Practice Address - Phone:520-881-2966
Practice Address - Fax:520-881-1341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-19
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty