| NPI | 1821621467 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AILEEN C KIM Dentist 703-823-8812 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 1223E0200X Dentist Endodontics |
| 1223P0300X Dentist Periodontics | |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2020-02-21 |
| Last Update Date | 2020-02-21 |