| NPI | 1386999282 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAN WON LEE Principal Member 703-573-0200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: VA 0401411868) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2013-01-22 |