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1609941400
JOHNNY KWAN NAM
FAIRFAX, VA
NPI
1609941400
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: VA 0401410729)
Enumeration Date
2006-11-21
Last Update Date
2007-07-08
Business Address
-- JOHNNY KWAN NAM D.D.S.
9561 BRADDOCK RD
FAIRFAX, VA 22032-2539
Phone number: 703-323-6500
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Mailing Address
-- JOHNNY KWAN NAM D.D.S.
9561 BRADDOCK RD
FAIRFAX, VA 22032-2539
Phone number: 703-323-6500
Copy
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