| Fairfax Dental Care | |
|
11001 Lee Hwy Ste A Fairfax VA 22030-5018 | |
| (703) 691-9740 | |
| (703) 691-9809 |
| Full Name | Fairfax Dental Care |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 11001 Lee Hwy Ste A, Fairfax, Virginia |
| Authorized Official Name and Position | Jung Soo Pak (DIRECTOR) |
| Authorized Official Contact | 7036919740 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairfax Dental Care 11001 Lee Hwy Ste A Fairfax VA 22030-5018 Ph: (703) 691-9740 | Fairfax Dental Care 11001 Lee Hwy Ste A Fairfax VA 22030-5018 Ph: (703) 691-9740 |
| NPI Number | 1366864480 |
|---|---|
| Provider Enumeration Date | 01/08/2014 |
| Last Update Date | 01/08/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366864480 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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