Organization
BRIGHT SMILE PEDIATRIC DENTIST PLLC
Active
Organization
BRIGHT SMILE PEDIATRIC DENTIST PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OSCAR ALDO LUNA (PEDIATRIC DENTIST)
(703) 462-8412
Entity
Organization
Contact information
Practice address
3001 ROBIN RIDGE CT, FAIRFAX, VA 22031-2133
(703) 462-8412
Mailing address
410 PINE ST SE, VIENNA, VA 22180-4861
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
0401410972
VA
Other
Enumeration date
05/09/2009
Last updated
05/09/2009
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