| Tru Smile Ahwatukee | |
|
4530 E Ray Rd Ste 170 Phoenix AZ 85044-6097 | |
| (480) 477-3090 | |
| Not Available |
| Full Name | Tru Smile Ahwatukee |
|---|---|
| Speciality | Clinic/Center |
| Location | 4530 E Ray Rd Ste 170, Phoenix, Arizona |
| Authorized Official Name and Position | Tracy Tran (MANAGER) |
| Authorized Official Contact | 4804773090 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tru Smile Ahwatukee 4530 E Ray Rd Ste 170 Phoenix AZ 85044-6097 Ph: (480) 477-3090 | Tru Smile Ahwatukee 4530 E Ray Rd Ste 170 Phoenix AZ 85044-6097 Ph: (480) 477-3090 |
| NPI Number | 1881281889 |
|---|---|
| Provider Enumeration Date | 12/23/2020 |
| Last Update Date | 12/28/2020 |
| Certification Date | 12/28/2020 |
| Medicare PECOS PAC ID | 3476921156 |
|---|---|
| Medicare Enrollment ID | O20221130002798 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881281889 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (NU) | Secondary |
| 261QD0000X | Clinic/center - Dental | (NU) | Primary |
| 122300000X | Dentist | (NU) | Secondary |
| Provider Name | Han Choi |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1891040028 PECOS PAC ID: 6103186390 Enrollment ID: I20211006001929 |
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