Organization
KINGS PARK DENTAL, LLC
Active
Other names
Kings Park Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TYLER YI DDS (OWNER/GENERAL DENTIST)
(571) 407-5981
Entity
Organization
Contact information
Practice address
8942 BURKE LAKE RD, SPRINGFIELD, VA 22151-1004
(571) 407-5981
(571) 407-7238
Mailing address
8942 BURKE LAKE RD, SPRINGFIELD, VA 22151-1004
(571) 407-5981
(571) 407-7238
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/20/2020
Last updated
08/20/2020
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