Organization
LET'S SMILE OF FAIRFAX PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALI YOUSEF GHATRI DDS (CHIEF EXECUTIVE OFFICER)
(703) 719-5828
Entity
Organization
Contact information
Practice address
4210 FAIRFAX CORNER AVE W, SUITE 245, FAIRFAX, VA 22030-8619
(703) 719-5828
(703) 691-8877
Mailing address
4210 FAIRFAX CORNER AVE W, SUITE 245, FAIRFAX, VA 22030-8619
(703) 719-5828
(703) 691-8877
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
0401007980
VA
Other
Enumeration date
03/30/2012
Last updated
03/30/2012
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