Healthcare Provider Details

I. General information

NPI: 1679828297
Provider Name (Legal Business Name): TUCSON SMILES PEDIATRIC DENTISTRY AS SWAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2012
Last Update Date: 07/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2810 N SWAN RD STE 140
TUCSON AZ
85712-6300
US

IV. Provider business mailing address

2810 N SWAN RD STE 140
TUCSON AZ
85712-6300
US

V. Phone/Fax

Practice location:
  • Phone: 520-881-2966
  • Fax: 520-881-1341
Mailing address:
  • Phone: 520-881-2966
  • Fax: 520-881-1341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. PRIYA YAMINI ABRAMIAN
Title or Position: PEDIATRIC DENTIST
Credential: DDS
Phone: 520-544-4171