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General NPI Number Information
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NPI Number | 1760818520
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Entity Type | Organization
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Legal Business Name | SMILES OF BEAUTY OF EL MIRAGE, PC
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Dates
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Enumeration Date | 09/24/2013
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Last Update Date | 09/24/2013
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Provider Practice Location Address
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Address Line | 10111 N EL MIRAGE RD SUITE 4
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City | EL MIRAGE
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State | AZ
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Zip | 85335-3605
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Country | US
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Telephone | 623-551-5444
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Fax | 623-935-3777
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Provider Business Mailing Address
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Address Line | 10111 N EL MIRAGE RD SUITE 4
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City | EL MIRAGE
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State | AZ
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Zip | 85335-3605
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Country | US
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Telephone | 623-551-5444
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Fax | 623-935-3777
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. HASSAN A BEYRAMIAN
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Credential | D.D.S.
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Telephone | 623-557-5444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D6373
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License Number State | AZ
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