Organization
LORTON PEDIATRIC DENTISTRY AND ORTHODONTICS, PLLC
Active
Other names
Smileworld
Organization subpart
No
Provider details
NPI number
Authorized official
SASHA GROSS (OPERATIONS MANAGER)
(240) 601-3932
Entity
Organization
Contact information
Practice address
8998 LORTON STATION BLVD STE E&F, LORTON, VA 22079-4789
(703) 344-0590
Mailing address
14573 POTOMAC MILLS RD, WOODBRIDGE, VA 22192-6808
(703) 499-9779
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
07/18/2024
Last updated
07/30/2024
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