| NPI | 1629408174 |
|---|---|
| Doing Business As | AWESOME SMILES DENTAL CENTER |
| Entity Type | Organization |
| Authorized Contact | TONTRA PETRICE LOWE Manager/Owner 571-261-2600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401411583) |
| Enumeration Date | 2013-11-20 |
| Last Update Date | 2013-11-20 |