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Dental Providers Dentist Pediatric Dentistry

Provider NPI: 1144631706

Organization Information:
Organization Name:  DC LIGHT DENTAL, PC
Organization is not Subpart
Authorized Official:  JONG  LEE  PRESIDENT  202-347-0100

Practice Location:
Tel: 202-347-0100  Fax: 202-347-3703

Business Mailing Address:
Tel: 202-347-0100  Fax: 202-347-3703

NPI Information:
NPI: 1144631706
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
N1223P0221XDental Providers
Pediatric Dentistry
N1223S0112XDental Providers
Y122300000XDental Providers
DCDEN 100768

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 122300000X





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