Organization Name: | SUN OK SUK, DDS, PC |
NPI Number: | 1689006629 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SUN OK SUK (PRESIDENT) |
Mailing Address: | 2136 Gallows Rd Ste B Dunn Loring |
State: | VA US |
Postal Code: | 220271036 |
Phone Number: | 7036985400 |
Fax Number: | 7036410237 |
NPI Enumeration Date: | 08/01/2013 |
NPI Last Update Date: | 08/01/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | 0401006359 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |