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General NPI Number Information
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NPI Number | 1396954830
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Entity Type | Organization
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Legal Business Name | RYAN M SCHWENDIMAN, DMD, PLLC
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10135 COLVIN RUN RD STE 230
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City | GREAT FALLS
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State | VA
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Zip | 22066-1874
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Country | US
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Telephone | 703-757-0833
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Fax |
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Provider Business Mailing Address
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Address Line | 10135 COLVIN RUN RD STE 230
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City | GREAT FALLS
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State | VA
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Zip | 22066-1874
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Country | US
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Telephone | 703-757-0833
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RYAN M SCHWENDIMAN
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Credential | DMD, MBA
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Telephone | 703-757-0833
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 0401410189
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License Number State | VA
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