Organization
SMILEVILLE PLLC
Active
Other names
Reform Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALI AL-DOURI DDS (DIRECTOR)
(540) 237-1700
Entity
Organization
Contact information
Practice address
10009 SOUTHPOINT PKWY STE 201, FREDERICKSBURG, VA 22407-2710
(540) 237-1700
Mailing address
8223 COTTAGE ST, VIENNA, VA 22180-6940
(202) 680-0866
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780120717
—
VA
Enumeration date
05/29/2019
Last updated
05/29/2019
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