| Lets Smile Ortho Fairfax Pllc | |
|
4210 Fairfax Corner Ave W Ste 245 Fairfax VA 22030-8627 | |
| (818) 533-8911 | |
| Not Available |
| Full Name | Lets Smile Ortho Fairfax Pllc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 4210 Fairfax Corner Ave W Ste 245, Fairfax, Virginia |
| Authorized Official Name and Position | Ali Y Ghatri (MANAGER) |
| Authorized Official Contact | 7037195828 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lets Smile Ortho Fairfax Pllc 4210 Fairfax Corner Ave W Ste 245 Fairfax VA 22030-8627 Ph: (703) 719-5828 | Lets Smile Ortho Fairfax Pllc 4210 Fairfax Corner Ave W Ste 245 Fairfax VA 22030-8627 Ph: (818) 533-8911 |
| NPI Number | 1043984784 |
|---|---|
| Provider Enumeration Date | 08/05/2021 |
| Last Update Date | 08/05/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043984784 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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