| Small Smiles Of Manassas, Llc | |
|
9012 Mathis Ave Manassas VA 20110-5218 | |
| (571) 921-1111 | |
| Not Available |
| Full Name | Small Smiles Of Manassas, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 9012 Mathis Ave, Manassas, Virginia |
| Authorized Official Name and Position | Trudy Williams (DIRECTOR, LICENSING & CREDENTIALING) |
| Authorized Official Contact | 6157500342 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Small Smiles Of Manassas, Llc 201 W 8th St Suite 810 Pueblo CO 81003-3038 Ph: (719) 562-4447 | Small Smiles Of Manassas, Llc 9012 Mathis Ave Manassas VA 20110-5218 Ph: (571) 921-1111 |
| NPI Number | 1780718676 |
|---|---|
| Provider Enumeration Date | 03/15/2007 |
| Last Update Date | 05/17/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780718676 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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