Provider Demographics
NPI:1083823199
Name:WARD BYRNE DENTAL GROUP
Entity Type:Organization
Organization Name:WARD BYRNE DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DENISON
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:BYRNE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-583-7010
Mailing Address - Street 1:1104 KENILWORTH DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2101
Mailing Address - Country:US
Mailing Address - Phone:410-583-7010
Mailing Address - Fax:410-583-2272
Practice Address - Street 1:1104 KENILWORTH DR
Practice Address - Street 2:SUITE 102
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-2101
Practice Address - Country:US
Practice Address - Phone:410-583-7010
Practice Address - Fax:410-583-2272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD66701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty