Organization
FIRST IMPRESSION ORTHODONTICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HUNG QUOC CHAU LU D.D.S., M.S. (PRESIDENT/ORTHODONTIST)
(703) 626-0333
Entity
Organization
Contact information
Practice address
6479 OLD BEULAH ST, ALEXANDRIA, VA 22315
(703) 626-0333
Mailing address
6479 OLD BEULAH ST, ALEXANDRIA, VA 22315
(703) 626-0333
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
0401412785
VA
Other
Enumeration date
04/10/2015
Last updated
04/10/2015
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