| Crystal Smile, Pllc | |
|
2611 Jefferson Davis Hwy Ste 200 Arlington VA 22202-4043 | |
| (571) 295-4200 | |
| Not Available |
| Full Name | Crystal Smile, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2611 Jefferson Davis Hwy Ste 200, Arlington, Virginia |
| Authorized Official Name and Position | Jason Favagehi (PRESIDENT) |
| Authorized Official Contact | 7033561200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crystal Smile, Pllc 8304 Old Courthouse Rd Ste C Vienna VA 22182-3881 Ph: (703) 356-1200 | Crystal Smile, Pllc 2611 Jefferson Davis Hwy Ste 200 Arlington VA 22202-4043 Ph: (571) 295-4200 |
| NPI Number | 1639724461 |
|---|---|
| Provider Enumeration Date | 08/08/2019 |
| Last Update Date | 08/08/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639724461 | NPI | - | NPPES |
| 0401007352 | Other | VA | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Gentle Care Dentists Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 901 N Stuart Street, Suite 101, Arlington, VA 22203 Phone: 703-822-5583 | |
Riverside Dental, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3400 S Clark St Ste 105, Arlington, VA 22202 Phone: 703-740-8978 Fax: 571-464-6588 | |