# ANNANDALE DIAMOND DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Healthy Smiles Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962133769
- **Authorized official:** KEISY SILES (INSURANCE COORDINATOR)
- **Authorized official phone:** (703) 204-1771

## Contact information

- **Practice address:** 3000 ANNANDALE RD STE 106, FALLS CHURCH, VA 22042-2702
- **Practice address phone:** (703) 204-1771
- **Mailing address:** 3000 ANNANDALE RD STE 106, FALLS CHURCH, VA 22042-2702

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 06/22/2022
- **Last updated:** 06/22/2022