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1770042723
BROAD SMILE DENTISTRY
HENRICO, VA
NPI
1770042723
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Entity Type
Organization
Authorized Contact
MYUNGSUK KOH
Officer
804-913-1710
Organization Subpart ?
No
Primary Taxonomy
261QD0000X Clinic/Center, Dental
Enumeration Date
2019-03-19
Last Update Date
2019-03-19
Business Address
BROAD SMILE DENTISTRY
4017 LAUDERDALE DR
HENRICO, VA 23233-1082
Phone number: 804-913-1710
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Mailing Address
BROAD SMILE DENTISTRY
4017 LAUDERDALE DR
HENRICO, VA 23233-1082
Phone number: 804-913-1710
Copy
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