| NPI | 1275489171 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEE SUN KIM Owner 571-263-4824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2026-03-05 |
| Last Update Date | 2026-03-05 |