Individual
JESSICA KO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6428 GEORGIA AVE NW, WASHINGTON, DC 20012-2910
(202) 723-0303
Mailing address
22 M ST NE APT 611, WASHINGTON, DC 20002-6783
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401416702
VA
Other
Enumeration date
09/26/2019
Last updated
09/26/2019
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