Fair Lakes Family and Cosmetic Dentistry

NPI #1427322734 in Fairfax, Virginia

Provider Information

NPI Number: 1427322734
Entity Type: Organization
Organization Name: Fair Lakes Family and Cosmetic Dentistry
Primary Specialty: Dentist - General Practice
Enumeration Date: Mar 5, 2012
Last Updated: Mar 5, 2012

Practice Location

Address: 12110 MONUMENT DR STE A
City: Fairfax
State: Virginia
ZIP Code: 22033-5553
Phone: (703) 273-4505

Authorized Official

Name: DR. ANNAH P TRAN, DDS
Title: DENTIST, PRESIDENT
Phone: (703) 273-4505

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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