Organization
DC LIGHT DENTAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONG LEE (PRESIDENT)
(202) 347-0100
Entity
Organization
Contact information
Practice address
1331 PENNSYLVANIA AVE NW STE 502, WASHINGTON, DC 20004-1771
(202) 347-0100
(202) 347-3703
Mailing address
1331 PENNSYLVANIA AVE NW STE 502, WASHINGTON, DC 20004-1771
(202) 347-0100
(202) 347-3703
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEN 100768
DC
1223P0221X
Pediatric Dentistry
DEN1001330
DC
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DEN1001175
DC
Other
Enumeration date
05/16/2014
Last updated
05/16/2014
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