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General NPI Number Information
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NPI Number | 1053022129
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Entity Type | Organization
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Legal Business Name | MESA SMILES DENTISTRY
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Dates
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Enumeration Date | 12/09/2022
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Last Update Date | 12/09/2022
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Provider Practice Location Address
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Address Line | 849 N DOBSON RD STE 108
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City | MESA
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State | AZ
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Zip | 85201-7596
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Country | US
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Telephone | 480-834-7777
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Fax |
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Provider Business Mailing Address
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Address Line | 6035 N 83RD ST
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City | SCOTTSDALE
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State | AZ
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Zip | 85250-5841
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Country | US
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Telephone | 716-430-5757
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALHARETH DHARI
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Credential | DMD
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Telephone | 716-430-5757
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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