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General NPI Number Information
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NPI Number | 1013212505
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Entity Type | Organization
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Legal Business Name | JAY I. CHASON
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Dates
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Enumeration Date | 01/14/2011
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Last Update Date | 01/14/2011
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Provider Practice Location Address
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Address Line | 15 E MAIN ST SUITE 222
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City | WESTMINSTER
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State | MD
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Zip | 21157-5000
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Country | US
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Telephone | 410-857-2802
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Fax | 410-857-2803
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Provider Business Mailing Address
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Address Line | 15 E MAIN ST SUITE 222
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City | WESTMINSTER
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State | MD
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Zip | 21157-5000
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Country | US
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Telephone | 410-857-2802
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Fax | 410-857-2803
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Authorized Official
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Title or Position | SECRETARY
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Name | CYNTHIA A SIMASNKI
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Credential |
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Telephone | 410-857-2802
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 10404
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License Number State | MD
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