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General NPI Number Information
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NPI Number | 1457944985
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Entity Type | Organization
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Legal Business Name | SMILE EXPERTS
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Dates
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Enumeration Date | 02/16/2021
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Last Update Date | 02/16/2021
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Provider Practice Location Address
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Address Line | 1747 PENNSYLVANIA AVE NW STE 100
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City | WASHINGTON
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State | DC
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Zip | 20006-4604
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Country | US
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Telephone | 630-877-4989
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Fax |
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Provider Business Mailing Address
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Address Line | 10658 CANTERBERRY RD
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City | FAIRFAX STATION
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State | VA
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Zip | 22039-1924
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Country | US
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Telephone | 630-877-4989
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. ANDLEEB REHMAN MAHMOOD
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Credential | DDS
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Telephone | 630-877-4989
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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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