| NPI | 1982814133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN K LEE Dentist 703-830-9990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: VA 0401007961) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-08-22 |