# FUSION DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** RESTON DENTAL GROUP, PC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1508445644
- **Legal business name:** RESTON DENTAL GROUP, PC
- **Authorized official:** JAIME BYERLY (DIRECTOR)
- **Authorized official phone:** (202) 699-1027

## Contact information

- **Practice address:** 11107 SUNSET HILLS RD STE 111, RESTON, VA 20190-5375
- **Practice address phone:** (703) 860-3200
- **Mailing address:** 11107 SUNSET HILLS RD STE 111, RESTON, VA 20190-5375
- **Mailing address phone:** (703) 860-3200

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 04/06/2021
- **Last updated:** 04/06/2021