Organization
GRACEFUL SMILES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW KIM (MANAGER)
(703) 677-7202
Entity
Organization
Contact information
Practice address
6120 BRANDON AVE STE 317, SPRINGFIELD, VA 22150-2504
(703) 451-3303
Mailing address
6120 BRANDON AVE STE 317, SPRINGFIELD, VA 22150-2504
(703) 451-3303
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
12/05/2020
Last updated
12/05/2020
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