Organization
ASHBURN DIVINE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LULU LIN (PRESIDENT)
(626) 377-0550
Entity
Organization
Contact information
Practice address
20915 ASHBURN RD STE 205, ASHBURN, VA 20147-5679
(626) 377-0550
Mailing address
20915 ASHBURN RD STE 205, ASHBURN, VA 20147-5679
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401413081
VA
Other
Enumeration date
10/05/2012
Last updated
10/05/2012
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