Individual
JOHN LEE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13916 METROTECH DR, CHANTILLY, VA 20151-3238
(703) 488-9922
Mailing address
20 WILLIAMS BLVD APT 1A, LAKE GROVE, NY 11755-2419
(703) 946-5299
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401417676
VA
Other
Enumeration date
09/24/2021
Last updated
06/24/2024
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