Organization
PURE DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAE-WOO JUNG DDS (OWNER DOCTOR)
(571) 236-6699
Entity
Organization
Contact information
Practice address
11864 SUNRISE VALLEY DR STE 100, RESTON, VA 20191-3311
(571) 236-6699
Mailing address
4631 HUMMINGBIRD LN, FAIRFAX, VA 22033-3745
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/13/2023
Last updated
10/13/2023
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