| Ashburn Divine Dental | |
|
20915 Ashburn Rd Ste 205 Ashburn VA 20147-5679 | |
| (626) 377-0550 | |
| Not Available |
| Full Name | Ashburn Divine Dental |
|---|---|
| Speciality | Dentist |
| Location | 20915 Ashburn Rd Ste 205, Ashburn, Virginia |
| Authorized Official Name and Position | Lulu Lin (PRESIDENT) |
| Authorized Official Contact | 6263770550 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ashburn Divine Dental 20915 Ashburn Rd Ste 205 Ashburn VA 20147-5679 Ph: () - | Ashburn Divine Dental 20915 Ashburn Rd Ste 205 Ashburn VA 20147-5679 Ph: (626) 377-0550 |
| NPI Number | 1750633301 |
|---|---|
| Provider Enumeration Date | 10/05/2012 |
| Last Update Date | 10/05/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750633301 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 0401413081 (Virginia) | Primary |
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