# CENTER FOR ORAL AND MAXILLOFACIAL RECONSTRUCTIVE SURGERY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508166562
- **Authorized official:** DR. ALI PASHAPOUR (PRESIDENT)
- **Authorized official phone:** (973) 223-2678

## Contact information

- **Practice address:** 3001 HOSPITAL DR, CHEVERLY, MD 20785-1189
- **Practice address phone:** (973) 223-2678
- **Mailing address:** 3700 MASSACHUSETTS AVE NW, SUITE 116, WASHINGTON, DC 20016-5800
- **Mailing address phone:** (973) 223-2678

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 0401411854 | VA | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 14010 | MD | Yes |

## Other

- **Enumeration date:** 10/25/2010
- **Last updated:** 02/24/2012