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Organization
PRESTIGE DENTAL SPECIALISTS
Active
Organization
PRESTIGE DENTAL SPECIALISTS
Active
Other names
Center for Dentofacial Aesthetics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NORACHAI PHISUTHIKUL DDS (OWNER)
(703) 256-2556
Entity
Organization
Contact information
Practice address
7630 LITTLE RIVER TPKE, 115, ANNANDALE, VA 22003-2610
(703) 256-2556
(703) 256-7722
Mailing address
7630 LITTLE RIVER TPKE, 115, ANNANDALE, VA 22003-2610
(703) 256-2556
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401412751
VA
Other
Enumeration date
05/05/2015
Last updated
05/05/2015
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