| Nova Lifesmiles Pllc | |
|
17 Fort Evans Rd Ne Ste C Leesburg VA 20176-4400 | |
| (703) 777-5025 | |
| Not Available |
| Full Name | Nova Lifesmiles Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 17 Fort Evans Rd Ne Ste C, Leesburg, Virginia |
| Authorized Official Name and Position | Josef Wollmann (MANAGER) |
| Authorized Official Contact | 9493500122 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nova Lifesmiles Pllc 21866 Engleside Pl Broadlands VA 20148-4543 Ph: (949) 350-0122 | Nova Lifesmiles Pllc 17 Fort Evans Rd Ne Ste C Leesburg VA 20176-4400 Ph: (703) 777-5025 |
| NPI Number | 1003479627 |
|---|---|
| Provider Enumeration Date | 04/18/2019 |
| Last Update Date | 04/18/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003479627 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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