Organization
BRITE SMILE DENTAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAEWON YOON DMD (OWNER)
(703) 447-5204
Entity
Organization
Contact information
Practice address
14631 LEE HWY STE 116, CENTREVILLE, VA 20121-5825
(703) 447-5204
Mailing address
14631 LEE HWY STE 116, CENTREVILLE, VA 20121-5825
(703) 447-5204
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
0401412648
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
026866600
—
MD
Enumeration date
08/29/2013
Last updated
08/30/2013
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