# SU-EN C THLICK, DMD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023207792
- **Authorized official:** DR. SU-EN C THLICK DMD (DENTIST/ OWNER)
- **Authorized official phone:** (703) 670-2114

## Contact information

- **Practice address:** 12701 MARBLESTONE DR, SUITE \#260, WOODBRIDGE, VA 22192-8307
- **Practice address phone:** (703) 670-2114
- **Mailing address:** 12701 MARBLESTONE DR, SUITE \#260, WOODBRIDGE, VA 22192-8307
- **Mailing address phone:** (703) 670-2114

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | VA | Yes |

## Other

- **Enumeration date:** 10/18/2007
- **Last updated:** 10/18/2007