DEEP ROOTS PERIODONTICS PLLC

FAIRFAX, VA
NPI1255695243
Entity TypeOrganization
Authorized ContactTAEHEON KANG
Periodontis
954-536-1111
Organization Subpart ?No
Primary Taxonomy1223P0300X Dentist, Periodontics
(Licence: VA  0401-413327)
Enumeration Date2012-06-25
Last Update Date2012-06-25
Business Address
DEEP ROOTS PERIODONTICS PLLC
11130 FAIRFAX BLVD SUITE 100
FAIRFAX, VA 22030-5035
Phone number: 954-536-1111
Mailing Address
DEEP ROOTS PERIODONTICS PLLC
11130 FAIRFAX BLVD SUITE 100
FAIRFAX, VA 22030-5035
Phone number: 954-536-1111