# MARYLAND ORAL SURGERY ASSOCIATES, LLC

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

## Provider details

- **NPI number:** 1326159179
- **Authorized official:** DR. GLENN A NATHAN D.D.S. (PRESIDENT)
- **Authorized official phone:** (301) 340-6884

## Contact information

- **Practice address:** 14955 SHADY GROVE ROAD, SUITE 330, ROCKVILLE, MD 20850-8700
- **Practice address phone:** (301) 340-0101
- **Practice address fax:** (301) 340-1689
- **Mailing address:** 14955 SHADY GROVE ROAD, SUITE 350, ROCKVILLE, MD 20850-8700
- **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) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 08/08/2023