| Fairfax Dentistry, Pllc | |
|
11351 Random Hills Rd Ste 102 Fairfax VA 22030-6081 | |
| (703) 691-2221 | |
| (703) 691-3215 |
| Full Name | Fairfax Dentistry, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 11351 Random Hills Rd Ste 102, Fairfax, Virginia |
| Authorized Official Name and Position | Samuel Saeho Ham (OWNER/DENTIST) |
| Authorized Official Contact | 7036912221 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairfax Dentistry, Pllc 11351 Random Hills Rd Ste 102 Fairfax VA 22030-6081 Ph: (703) 691-2221 | Fairfax Dentistry, Pllc 11351 Random Hills Rd Ste 102 Fairfax VA 22030-6081 Ph: (703) 691-2221 |
| NPI Number | 1710496294 |
|---|---|
| Provider Enumeration Date | 09/27/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710496294 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Virginia) | Primary |
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