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General NPI Number Information
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NPI Number | 1043895808
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Entity Type | Organization
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Legal Business Name | UR SMILE DENTAL
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Dates
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Enumeration Date | 03/13/2021
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Last Update Date | 06/25/2021
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Provider Practice Location Address
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Address Line | 201 ELDEN ST STE 102
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City | HERNDON
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State | VA
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Zip | 20170-4812
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Country | US
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Telephone | 571-877-6453
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Fax | 571-466-2783
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Provider Business Mailing Address
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Address Line | 201 ELDEN ST STE 102
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City | HERNDON
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State | VA
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Zip | 20170-4812
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Country | US
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Telephone | 571-877-6453
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Fax | 571-466-2783
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MANPREET KAUR
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Credential |
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Telephone | 571-877-6453
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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