Provider Demographics
NPI:1306052956
Name:STREIGHT SMILE CENTER, PLLC
Entity type:Organization
Organization Name:STREIGHT SMILE CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:STREIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:623-584-3965
Mailing Address - Street 1:18775 N REEMS RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-8647
Mailing Address - Country:US
Mailing Address - Phone:623-584-3965
Mailing Address - Fax:623-584-0130
Practice Address - Street 1:18775 N REEMS RD
Practice Address - Street 2:SUITE 300
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-8647
Practice Address - Country:US
Practice Address - Phone:623-584-3965
Practice Address - Fax:623-584-0130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty