Organization
FUSION DENTAL
Active
Parent organization
GREATER MARYLAND DENTAL PARTNERS
Other names
Greater Maryland Dental Partners
Organization subpart
Yes
Provider details
NPI number
Legal business name
GREATER MARYLAND DENTAL PARTNERS
Authorized official
JAIME BYERLY DO (DIRECTOR, OPERATIONS)
(202) 699-1027
Entity
Organization
Contact information
Practice address
1401 CHAIN BRIDGE RD, MC LEAN, VA 22101-6026
(703) 821-1633
Mailing address
1401 CHAIN BRIDGE RD, MC LEAN, VA 22101-6026
(703) 821-1633
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
401007478
VA
1223P0221X
Pediatric Dentistry
401410040
VA
Other
Enumeration date
07/17/2018
Last updated
07/17/2018
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