Provider Demographics
NPI:1558867481
Name:JONES FALLS DENTAL LLC
Entity Type:Organization
Organization Name:JONES FALLS DENTAL LLC
Other - Org Name:JONES FALLS DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:FIONA
Authorized Official - Middle Name:
Authorized Official - Last Name:VISMANS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-206-5416
Mailing Address - Street 1:3000 FALLS RD APT 322
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-2477
Mailing Address - Country:US
Mailing Address - Phone:410-206-5416
Mailing Address - Fax:
Practice Address - Street 1:2 HAMILL RD STE 265
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210-1885
Practice Address - Country:US
Practice Address - Phone:410-435-8200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-31
Last Update Date:2018-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental