| Goose Creek Village Dental | |
|
21001 Sycolin Rd Suite 240 Ashburn VA 20147-4073 | |
| (703) 723-4224 | |
| (703) 723-4220 |
| Full Name | Goose Creek Village Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 21001 Sycolin Rd, Ashburn, Virginia |
| Authorized Official Name and Position | Michael H Kim (DENTIST / PARTNER) |
| Authorized Official Contact | 7037234224 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Goose Creek Village Dental 21001 Sycolin Rd Suite 240 Ashburn VA 20147-4073 Ph: (703) 723-4224 | Goose Creek Village Dental 21001 Sycolin Rd Suite 240 Ashburn VA 20147-4073 Ph: (703) 723-4224 |
| NPI Number | 1902207327 |
|---|---|
| Provider Enumeration Date | 09/05/2014 |
| Last Update Date | 09/05/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902207327 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 0401413573 (Virginia) | Primary |
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