Ashburn Divine Dental

NPI #1750633301 in Ashburn, Virginia

Provider Information

NPI Number: 1750633301
Entity Type: Organization
Organization Name: Ashburn Divine Dental
Primary Specialty: Dentist
Enumeration Date: Oct 5, 2012
Last Updated: Oct 5, 2012

Practice Location

Address: 20915 ASHBURN RD STE 205
City: Ashburn
State: Virginia
ZIP Code: 20147-5679
Phone: (626) 377-0550

Authorized Official

Name: LULU LIN
Title: PRESIDENT
Phone: (626) 377-0550

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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