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General NPI Number Information
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NPI Number | 1386999282
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Entity Type | Organization
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Legal Business Name | MERRIFIELD ORTHODONTICS PLLC
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Dates
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Enumeration Date | 07/17/2012
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Last Update Date | 01/22/2013
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Provider Practice Location Address
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Address Line | 2843 HARTLAND RD SUITE 100
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City | FALLS CHURCH
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State | VA
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Zip | 22043-3527
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Country | US
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Telephone | 703-573-0200
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Fax |
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Provider Business Mailing Address
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Address Line | 2843 HARTLAND RD SUITE 100
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City | FALLS CHURCH
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State | VA
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Zip | 22043-3527
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Country | US
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Telephone | 703-573-0200
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Fax |
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Authorized Official
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Title or Position | PRINCIPAL MEMBER
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Name | DR. DAN WON LEE
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Credential | DDS
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Telephone | 703-573-0200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 0401411868
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License Number State | VA
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