| NPI | 1871852186 |
|---|---|
| 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 12859) |
| Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: MD 14075) |
| 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: MD 9161) | |
| Enumeration Date | 2012-05-07 |
| Last Update Date | 2024-04-17 |