| NPI | 1902477482 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOYCE H BAHNG President 703-444-4188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2021-07-07 |
| Last Update Date | 2021-07-07 |