NPI | 1164848370 |
---|---|
Former Legal Business Name | MARYLAND ORAL SURGERY ASSOCIATES OF FREDERICK, LLC |
Entity Type | Organization |
Authorized Contact | GLENN A. NATHAN President 301-340-6884 |
Organization Subpart ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MD 11347) |
Enumeration Date | 2014-03-12 |
Last Update Date | 2023-08-08 |