| NPI | 1720856370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIEU M LE Owner 703-382-5611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2023-12-13 |
| Last Update Date | 2025-09-22 |