NPI 1588898217

Bright Smile Pediatric Dentist PLLC

Organisation Exclusive Provider Organization Fairfax, VA

Practice location

Address: 3001 Robin Ridge CT, Fairfax, VA 22031-2133
Phone: (703) 462-8412
Mailing address: 410 Pine St SE, Vienna, VA 22180-4861

Authorised official

Name: Oscar Aldo Luna
Title: Pediatric Dentist
Phone: (703) 462-8412

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 0401410972 (VA)

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Registry record

NPI: 1588898217
Entity type: Organization
NPI issued: 9 May 2009
Record last updated: 9 May 2009

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.