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Individual

JAE KWON BOK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
7535 LITTLE RIVER TPKE, # 100 E, ANNANDALE, VA 22003-2937
(703) 336-3818
Mailing address
7535 LITTLE RIVER TPKE, # 100 E, ANNANDALE, VA 22003-2937
(703) 336-3818

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401411726
VA
1223G0001X
General Practice Dentistry
IL

Other

Enumeration date
09/01/2006
Last updated
02/03/2008
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