Dr. Shane Costa/little Smiles

NPI #1649618711 in Ashburn, Virginia

Provider Information

NPI Number: 1649618711
Entity Type: Organization
Organization Name: Dr. Shane Costa/little Smiles
Primary Specialty: Dentist
Enumeration Date: Jun 11, 2013
Last Updated: Jun 11, 2013

Practice Location

Address: 42395 RYAN RD
Address 2: SUITE 104
City: Ashburn
State: Virginia
ZIP Code: 20148-4863
Phone: (703) 757-0833

Authorized Official

Name: DR. SHANE R COSTA, D.D.S.
Title: DOCTOR/OWNER
Phone: (703) 757-0833

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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