Organization
HERNDON SMILE DESIGN PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE THORPE (CREDENTIALING SPECIALIST)
(410) 409-9202
Entity
Organization
Contact information
Practice address
504 ELDEN ST, HERNDON, VA 20170-4741
(703) 464-0000
(703) 464-0066
Mailing address
504 ELDEN ST, HERNDON, VA 20170-4741
(703) 464-0000
(703) 464-0066
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/30/2020
Last updated
04/01/2020
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