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Organization
AKESO OROFACIAL SURGERY, LLC
Active
Organization
AKESO OROFACIAL SURGERY, LLC
Active
Other names
Laurel Oral Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TREVANN LYN DMD (OWNER)
(301) 329-5758
Entity
Organization
Contact information
Practice address
13934 BALTIMORE AVE, LAUREL, MD 20707-5000
(301) 329-5758
(410) 665-3235
Mailing address
13934 BALTIMORE AVE, LAUREL, MD 20707-5000
(301) 329-5758
(410) 665-3235
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
—
NULL
Other
Enumeration date
07/05/2019
Last updated
07/05/2019
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