Provider Demographics
NPI:1114391760
Name:GEARY FAMILY & COSMETIC DENTISTRY
Entity Type:Organization
Organization Name:GEARY FAMILY & COSMETIC DENTISTRY
Other - Org Name:A DIVISION OF ATLANTIC DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:GEARY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:757-898-4661
Mailing Address - Street 1:PO BOX 1485
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23692-1485
Mailing Address - Country:US
Mailing Address - Phone:757-898-4661
Mailing Address - Fax:757-890-2227
Practice Address - Street 1:105 TERREBONNE RD
Practice Address - Street 2:
Practice Address - City:YORKTOWN
Practice Address - State:VA
Practice Address - Zip Code:23692-4817
Practice Address - Country:US
Practice Address - Phone:757-898-4661
Practice Address - Fax:757-890-2227
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ATLANTIC DENTAL CARE, PLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-11-19
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014118651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty