| NPI | 1912919663 |
|---|---|
| Other Name | FAIR CITY MALL DENTAL |
| Entity Type | Organization |
| Authorized Contact | TRUNG QUI LE President 703-978-3541 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401410629) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2020-08-22 |