Organization
JAY I. CHASON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA A SIMASNKI (SECRETARY)
(410) 857-2802
Entity
Organization
Contact information
Practice address
15 E MAIN ST, SUITE 222, WESTMINSTER, MD 21157-5000
(410) 857-2802
(410) 857-2803
Mailing address
15 E MAIN ST, SUITE 222, WESTMINSTER, MD 21157-5000
(410) 857-2802
(410) 857-2803
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
10404
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
498941400
—
MD
Enumeration date
01/14/2011
Last updated
01/14/2011
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