| Awesome Smiles Dental Center | |
|
6468 Trading Sq Haymarket VA 20169-2277 | |
| (571) 261-2600 | |
| (571) 261-2699 |
| Full Name | Awesome Smiles Dental Center |
|---|---|
| Speciality | Dentist |
| Location | 6468 Trading Sq, Haymarket, Virginia |
| Authorized Official Name and Position | Tontra Petrice Lowe (MANAGER/OWNER) |
| Authorized Official Contact | 5712612600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Awesome Smiles Dental Center 6468 Trading Sq Haymarket VA 20169-2277 Ph: (571) 261-2600 | Awesome Smiles Dental Center 6468 Trading Sq Haymarket VA 20169-2277 Ph: (571) 261-2600 |
| NPI Number | 1629408174 |
|---|---|
| Provider Enumeration Date | 11/20/2013 |
| Last Update Date | 11/20/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629408174 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 0401411583 (Virginia) | Primary |
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