MEDICARE: ARCADIA SMILES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1932769445
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARCADIA SMILES LLC

Provider Business Mailing Address
First Line	:	5638 E THOMAS RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-8117
Country	:	US
Telephone Number	:	480-990-2343
Fax Number	:	480-947-7937

Provider Business Practice Location Address
First Line	:	5638 E THOMAS RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-8117
Country	:	US
Telephone Number	:	480-990-2343
Fax Number	:	480-947-7937

Authorized Official
Title or Position	:	ADMIN
Name	:	PATRICIA A PEREZ
Credential	:
Telephone Number	:	623-419-2781

Provider Enumeration Date	:	06/17/2019
Last Update Date	:	06/17/2019

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Directions to “ARCADIA SMILES LLC ” Practice Location

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