| NPI | 1942568258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUNYOUNG KIM Dr 703-539-9166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: VA 0401412796) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: VA 0401412701) |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2012-04-25 |