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General NPI Number Information
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NPI Number | 1942434048
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Entity Type | Organization
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Legal Business Name | FIRST SMILE DENTAL PC
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Dates
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Enumeration Date | 05/05/2009
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Last Update Date | 05/06/2009
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Provider Practice Location Address
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Address Line | 8727A COOPER RD
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City | ALEXANDRIA
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State | VA
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Zip | 22309-3906
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Country | US
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Telephone | 571-312-6898
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Fax | 571-312-6897
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Provider Business Mailing Address
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Address Line | 8727A COOPER RD
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City | ALEXANDRIA
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State | VA
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Zip | 22309-3906
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Country | US
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Telephone | 571-312-6898
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Fax | 571-312-6897
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANHVU NGUYEN
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Credential | D.D.S
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Telephone | 571-312-6898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 0401410920
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License Number State | VA
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