MEDICARE: FRIENDSHIP DENTAL GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	3539	MD

General Provider Information

NPI Number	:	1205831930
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRIENDSHIP DENTAL GROUP

Provider Business Mailing Address
First Line	:	4500 N PARK AVE
Second Line	:	STE N803
City	:	CHEVY CHASE
State	:	MD
Zip	:	20815-7239
Country	:	US
Telephone Number	:	301-656-1106
Fax Number	:

Provider Business Practice Location Address
First Line	:	4500 N PARK AVE
Second Line	:	STE N803
City	:	CHEVY CHASE
State	:	MD
Zip	:	20815-7239
Country	:	US
Telephone Number	:	301-656-1106
Fax Number	:

Authorized Official
Title or Position	:	PARTNER
Name	:	DR. RONALD ADAM POMYKALA
Credential	:	DDS
Telephone Number	:	301-656-1106

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	08/22/2020

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