Sporting Smiles Pediatric Dentistry & Family Orthodontics | |
7915 Lake Manassas Dr Suite 301 Gainesville VA 20155-3258 | |
(571) 248-1501 | |
(703) 563-9237 |
Full Name | Sporting Smiles Pediatric Dentistry & Family Orthodontics |
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Speciality | Dentist - Pediatric Dentistry |
Location | 7915 Lake Manassas Dr, Gainesville, Virginia |
Authorized Official Name and Position | Natasha Khurana (OWNER, PEDIATRIC DENTIST) |
Authorized Official Contact | 5712481501 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Sporting Smiles Pediatric Dentistry & Family Orthodontics 7915 Lake Manassas Dr Suite 301 Gainesville VA 20155-3258 Ph: (571) 248-1501 | Sporting Smiles Pediatric Dentistry & Family Orthodontics 7915 Lake Manassas Dr Suite 301 Gainesville VA 20155-3258 Ph: (571) 248-1501 |
NPI Number | 1770912560 |
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Provider Enumeration Date | 11/02/2013 |
Last Update Date | 11/02/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770912560 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0221X | Dentist - Pediatric Dentistry | 0401413436 (Virginia) | Primary |
1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 0401412461 (Virginia) | Secondary |
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