# MARYLAND ORAL SURGERY ASSOCIATES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Maryland Oral Surgery Associates of Frederick, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164848370
- **Authorized official:** DR. GLENN A. NATHAN D.D.S. (PRESIDENT)
- **Authorized official phone:** (301) 340-6884

## Contact information

- **Practice address:** 161 THOMAS JOHNSON DR STE 295, FREDERICK, MD 21702-4314
- **Practice address phone:** (301) 698-5208
- **Practice address fax:** (301) 698-1848
- **Mailing address:** 14955 SHADY GROVE RD., SUITE 350, ROCKVILLE, MD 20850
- **Mailing address phone:** (301) 340-6884
- **Mailing address fax:** (301) 340-3836

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 11347 | MD | Yes |

## Other

- **Enumeration date:** 03/12/2014
- **Last updated:** 08/08/2023