Organization
SMILES 4 FAIRFAX, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOWARD THE NGO (OWNER/ DOCTOR)
(703) 865-6677
Entity
Organization
Contact information
Practice address
11351 RANDOM HILLS RD, SUITE 290, FAIRFAX, VA 22030-6081
(703) 865-6677
(703) 865-6680
Mailing address
11351 RANDOM HILLS RD, SUITE 290, FAIRFAX, VA 22030-6081
(703) 865-6677
(703) 865-6680
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401411836
VA
1223G0001X
General Practice Dentistry
0401414383
VA
Other
Enumeration date
03/04/2016
Last updated
03/04/2016
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