Organization
ICON DPMG LLC
Active
Other names
Icon Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HYUNG-JUNG AHN D.M.D. (OWNER/DIRECTOR)
(781) 861-6401
Entity
Organization
Contact information
Practice address
57 BEDFORD STREET, SUITE 220, LEXINGTON, MA 02420
(781) 861-6401
(781) 861-6258
Mailing address
57 BEDFORD STREET, SUITE 220, LEXINGTON, MA 02420
(781) 861-6401
(781) 861-6258
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/07/2007
Last updated
09/12/2011
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