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Organization
CENTRAL MARYLAND ORAL AND MAXILLOFACIAL SURGERY P.A.
Active
Organization
CENTRAL MARYLAND ORAL AND MAXILLOFACIAL SURGERY P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOMENICK COLETTI MD, DDS (VICE PRESIDENT)
(410) 997-1010
Entity
Organization
Contact information
Practice address
10710 CHARTER DR, SUITE 330, COLUMBIA, MD 21044-3128
(410) 997-1010
(410) 997-0807
Mailing address
10710 CHARTER DR, SUITE 330, COLUMBIA, MD 21044-3128
(410) 997-1010
(410) 997-0807
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
D0060424
MD
Other
Enumeration date
02/03/2010
Last updated
02/03/2010
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