Individual
WON HEO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4703 PONDEROSA DR, ANNANDALE, VA 22003-4221
(202) 430-6187
Mailing address
4703 PONDEROSA DR, ANNANDALE, VA 22003-4221
(202) 430-6187
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
2018005516
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/02/2016
Last updated
03/28/2023
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