Individual
DR. SANG-JIN SAMUEL NAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6120 BRANDON AVE STE 317, SPRINGFIELD, VA 22150-2504
(703) 451-3303
Mailing address
1567 MAIN ST, SPRINGFIELD, MA 01103-1413
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401416970
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/25/2018
Last updated
12/19/2020
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