Individual
SUSAN LE LUONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
3077 NUTLEY ST, FAIRFAX, VA 22031-1931
(703) 280-1100
(703) 280-1617
Mailing address
3077 NUTLEY ST, FAIRFAX, VA 22031-1931
(703) 280-1100
(703) 280-1617
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401410050
VA
Other
Enumeration date
04/27/2015
Last updated
04/27/2015
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