Organization
PEARLBRITE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOONGSEO KIM (OWNER)
(703) 988-9006
Entity
Organization
Contact information
Practice address
14631 LEE HWY STE 116, CENTREVILLE, VA 20121-5825
(703) 988-9006
Mailing address
301 MAPLE AVE W STE 610, VIENNA, VA 22180-4300
(703) 281-7011
(703) 281-7030
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
0401413569
VA
1223P0700X
Prosthodontics
Primary
0401008847
VA
1223P0700X
Prosthodontics
12296
MD
Other
Enumeration date
03/02/2016
Last updated
03/02/2016
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