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Organization

SU-EN C THLICK, DMD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SU-EN C THLICK DMD (DENTIST/ OWNER)
(703) 670-2114
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
VA

Other

Enumeration date
10/18/2007
Last updated
10/18/2007
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