| NPI | 1184328676 |
|---|---|
| Doing Business As | AVENUE SMILES |
| Entity Type | Organization |
| Authorized Contact | DONGHYUN KOO Owner 571-528-7767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-03-28 |
| Last Update Date | 2023-03-28 |