Organization
LETS SMILE ORTHO FAIRFAX PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALI Y GHATRI DDS (MANAGER)
(703) 719-5828
Entity
Organization
Contact information
Practice address
4210 FAIRFAX CORNER AVE W STE 245, FAIRFAX, VA 22030-8627
(818) 533-8911
Mailing address
4210 FAIRFAX CORNER AVE W STE 245, FAIRFAX, VA 22030-8627
(703) 719-5828
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
08/05/2021
Last updated
08/05/2021
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