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Organization
KINGS PARK DENTAL, LLC
Active
Organization
KINGS PARK DENTAL, LLC
Active
Other names
Kings Park Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TYLER YI DDS (OWNER/GENERAL DENTIST)
(571) 407-5981
Entity
Organization
Contact information
Practice address
8942 BURKE LAKE RD, SPRINGFIELD, VA 22151-1004
(571) 407-5981
(571) 407-7238
Mailing address
8942 BURKE LAKE RD, SPRINGFIELD, VA 22151-1004
(571) 407-5981
(571) 407-7238
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
08/20/2020
Last updated
08/20/2020
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