Organization
ALL SMILES ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SWATHI R. KUPPAM DMD (OWNER)
(703) 337-4414
Entity
Organization
Contact information
Practice address
9010 LORTON STATION BLVD, #260, LORTON, VA 22079-4792
(703) 337-4414
Mailing address
9010 LORTON STATION BLVD, #260, LORTON, VA 22079-4792
(703) 337-4414
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
0401411870
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9209379
—
VA
Enumeration date
03/31/2011
Last updated
03/31/2011
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