Provider Demographics
NPI:1083593693
Name:VIRTS PEDIATRIC DENTISTRY, LLC
Entity type:Organization
Organization Name:VIRTS PEDIATRIC DENTISTRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:TRESSLER
Authorized Official - Last Name:VIRTS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:240-513-6161
Mailing Address - Street 1:1150 OMEGA DR STE 102
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-5784
Mailing Address - Country:US
Mailing Address - Phone:240-513-6161
Mailing Address - Fax:
Practice Address - Street 1:1150 OMEGA DR STE 102
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5784
Practice Address - Country:US
Practice Address - Phone:240-513-6161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty