# KING ORAL SURGERY GROUP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** n/a
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679875033
- **Authorized official:** MICHEAL KING (PRESIDENT)
- **Authorized official phone:** (615) 293-3744

## Contact information

- **Practice address:** 11885 HOLLY LN STE 2, WALDORF, MD 20601-3187
- **Practice address phone:** (301) 645-4555
- **Mailing address:** 6368 COVENTRY WAY STE 197, CLINTON, MD 20735-2256

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 14203 | MD | Yes |

## Other

- **Enumeration date:** 11/17/2010
- **Last updated:** 11/17/2010