| Destination Smile | |
|
9010 Lorton Station Blvd Unit 120 Lorton VA 22079-4792 | |
| (703) 339-3993 | |
| Not Available |
| Full Name | Destination Smile |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 9010 Lorton Station Blvd, Lorton, Virginia |
| Authorized Official Name and Position | Flavia D Tingling (OWNER) |
| Authorized Official Contact | 7343585100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Destination Smile 9010 Lorton Station Blvd Unit 120 Lorton VA 22079-4792 Ph: (703) 339-3993 | Destination Smile 9010 Lorton Station Blvd Unit 120 Lorton VA 22079-4792 Ph: (703) 339-3993 |
| NPI Number | 1629309133 |
|---|---|
| Provider Enumeration Date | 01/22/2010 |
| Last Update Date | 01/22/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629309133 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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