# PRESTIGE DENTAL SPECIALISTS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Center for Dentofacial Aesthetics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073990594
- **Authorized official:** DR. NORACHAI PHISUTHIKUL DDS (OWNER)
- **Authorized official phone:** (703) 256-2556

## Contact information

- **Practice address:** 7630 LITTLE RIVER TPKE, 115, ANNANDALE, VA 22003-2610
- **Practice address phone:** (703) 256-2556
- **Practice address fax:** (703) 256-7722
- **Mailing address:** 7630 LITTLE RIVER TPKE, 115, ANNANDALE, VA 22003-2610
- **Mailing address phone:** (703) 256-2556

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 0401412751 | VA | Yes |

## Other

- **Enumeration date:** 05/05/2015
- **Last updated:** 05/05/2015