| NPI | 1477154516 |
|---|---|
| Doing Business As | OLD TOWN SMILES |
| Entity Type | Organization |
| Authorized Contact | KIM IERNA KITCHEN Owner/Dentist 703-836-7000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2020-11-05 |
| Last Update Date | 2020-11-05 |