Provider Demographics
NPI:1710738554
Name:MARK K CHOI DDS PC
Entity Type:Organization
Organization Name:MARK K CHOI DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:K
Authorized Official - Last Name:CHOI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-207-7077
Mailing Address - Street 1:8303 ARLINGTON BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-2903
Mailing Address - Country:US
Mailing Address - Phone:703-207-7077
Mailing Address - Fax:703-207-7066
Practice Address - Street 1:8303 ARLINGTON BLVD STE 105
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-2903
Practice Address - Country:US
Practice Address - Phone:703-207-7077
Practice Address - Fax:703-207-7066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental