| NPI | 1821155318 |
|---|---|
| Doing Business As | FUSION DENTAL - ASHBURN |
| Entity Type | Organization |
| Authorized Contact | HANNAH FISH Credentialing Manager 217-540-5699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2022-08-08 |