Goose Creek Village Dental

NPI #1902207327 in Ashburn, Virginia

Provider Information

NPI Number: 1902207327
Entity Type: Organization
Organization Name: Goose Creek Village Dental
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Sep 5, 2014
Last Updated: Sep 5, 2014

Practice Location

Address: 21001 SYCOLIN RD
Address 2: SUITE 240
City: Ashburn
State: Virginia
ZIP Code: 20147-4073
Phone: (703) 723-4224

Authorized Official

Name: MICHAEL H KIM, DDS
Title: DENTIST / PARTNER
Phone: (703) 723-4224

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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