Organization
SUPER SMILE CENTER OF TYSONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMISHA N SHROFF (OWNER / DENTIST)
(703) 532-4400
Entity
Organization
Contact information
Practice address
7115 LEESBUG PIKE, #216, FALLS CHURCH, VA 22043
(703) 532-4400
(703) 532-7400
Mailing address
7115 LEESBUG PIKE, 216, FALLS CHURCH, VA 22043
(703) 532-4400
(703) 532-7400
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401411963
VA
Other
Enumeration date
08/28/2016
Last updated
08/28/2016
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