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General NPI Number Information
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NPI Number | 1669848644
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Entity Type | Organization
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Legal Business Name | SKS DENTAL
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Dates
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Enumeration Date | 08/13/2015
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Last Update Date | 08/13/2015
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Provider Practice Location Address
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Address Line | 3801 FAIRFAX DR SUITE 22
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City | ARLINGTON
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State | VA
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Zip | 22203-1762
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Country | US
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Telephone | 202-297-1336
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Fax |
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Provider Business Mailing Address
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Address Line | 1309 SHAKER WOODS RD
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City | HERNDON
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State | VA
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Zip | 20170-2611
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Country | US
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Telephone | 202-297-1336
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SMITA SABHARWAL
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Credential | DDS
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Telephone | 202-297-1336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 0401410990
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License Number State | VA
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