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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