| NPI | 1144631706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONG LEE President 202-347-0100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: DC DEN 100768) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: DC DEN1001330) |
| 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: DC DEN1001175) | |
| Enumeration Date | 2014-05-16 |
| Last Update Date | 2014-05-16 |