Organization
TREASURED SMILES PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHRISTINE HICKERSON (OFFICE MANAGER)
(571) 293-0244
Entity
Organization
Contact information
Practice address
1509 DODONA TER STE 105A, LEESBURG, VA 20175-4709
(571) 293-0244
Mailing address
1509 DODONA TERRACE SUITE 105A, LEESBURG, VA 25405
(571) 293-0244
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
0401412920
VA
Other
Enumeration date
10/09/2013
Last updated
10/09/2013
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