| Fair Lakes Family And Cosmetic Dentistry | |
|
12110 Monument Dr Ste A Fairfax VA 22033-5553 | |
| (703) 273-4505 | |
| (703) 273-5757 |
| Full Name | Fair Lakes Family And Cosmetic Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 12110 Monument Dr Ste A, Fairfax, Virginia |
| Authorized Official Name and Position | Annah P Tran (DENTIST, PRESIDENT) |
| Authorized Official Contact | 7032734505 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fair Lakes Family And Cosmetic Dentistry 12110 Monument Dr Ste A Fairfax VA 22033-5553 Ph: (703) 273-4505 | Fair Lakes Family And Cosmetic Dentistry 12110 Monument Dr Ste A Fairfax VA 22033-5553 Ph: (703) 273-4505 |
| NPI Number | 1427322734 |
|---|---|
| Provider Enumeration Date | 03/05/2012 |
| Last Update Date | 03/05/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427322734 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 0401410709 (Virginia) | Primary |
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