NPI 1386910529

Let's Smile of Fairfax PLLC

Organisation Point of Service Fairfax, VA

Practice location

Address: 4210 Fairfax Corner Ave W Suite 245, Fairfax, VA 22030-8619
Phone: (703) 719-5828
Fax: (703) 691-8877

Authorised official

Name: Ali Yousef Ghatri
Title: Chief Executive Officer
Phone: (703) 719-5828

Registered specialties

Point of Service Primary

Managed Care Organizations Taxonomy 305S00000X Licence 0401007980 (VA)

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Registry record

NPI: 1386910529
Entity type: Organization
NPI issued: 30 Mar 2012
Record last updated: 30 Mar 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.