| NPI | 1225640394 |
|---|---|
| Doing Business As | KINGS PARK FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | TYLER YI Owner/General Dentist 571-407-5981 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-08-20 |
| Last Update Date | 2020-08-20 |