| Sjpark Dental, Pc | |
|
4001 Fair Ridge Dr Ste 105 Fairfax VA 22033-2917 | |
| (703) 352-0741 | |
| (703) 352-0046 |
| Full Name | Sjpark Dental, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4001 Fair Ridge Dr Ste 105, Fairfax, Virginia |
| Authorized Official Name and Position | Sungbum Park (DIRECTOR/ DENTIST) |
| Authorized Official Contact | 7033520741 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sjpark Dental, Pc 4001 Fair Ridge Dr Ste 105 Fairfax VA 22033-2917 Ph: (703) 352-0741 | Sjpark Dental, Pc 4001 Fair Ridge Dr Ste 105 Fairfax VA 22033-2917 Ph: (703) 352-0741 |
| NPI Number | 1245059492 |
|---|---|
| Provider Enumeration Date | 10/04/2024 |
| Last Update Date | 10/04/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245059492 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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