Individual
TIN WAI LI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
10801 MAIN ST, SUITE 500, FAIRFAX, VA 22030-4727
(703) 815-2041
(703) 345-0487
Mailing address
10801 MAIN ST, SUITE 500, FAIRFAX, VA 22030-4727
(703) 815-2041
(703) 345-0487
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401006274
VA
Other
Enumeration date
10/18/2006
Last updated
01/26/2009
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