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General NPI Number Information
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NPI Number | 1104238955
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Entity Type | Organization
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Legal Business Name | ACE ORTHODONTICS, PLLC
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Dates
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Enumeration Date | 05/28/2014
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Last Update Date | 05/28/2014
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Provider Practice Location Address
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Address Line | 2841 HARTLAND RD SUITE 302
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City | FALLS CHURCH
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State | VA
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Zip | 22043-3500
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Country | US
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Telephone | 703-938-1187
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Fax |
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Provider Business Mailing Address
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Address Line | 901 FARLEY CT SE
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City | VIENNA
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State | VA
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Zip | 22180-5916
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Country | US
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Telephone | 703-938-1187
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST/OWNER
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Name | DR. JU-HAN CHANG
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Credential | D.D.S., M.S.
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Telephone | 703-938-1187
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 0401413525
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License Number State | VA
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