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Organization
ORAL SURGERY OF MARYLAND, LLC JEROME CASPER SOLE MBR
Active
Organization
ORAL SURGERY OF MARYLAND, LLC JEROME CASPER SOLE MBR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA PERKINS (ONBOARDING SPECIALIST)
(678) 244-4844
Entity
Organization
Contact information
Practice address
13600 BALTIMORE AVE STE 200, LAUREL, MD 20707-9495
(770) 692-1000
Mailing address
PO BOX 14701, SAINT LOUIS, MO 63178-4701
(770) 692-1000
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
261QD0000X
Dental Clinic/Center
—
NULL
Other
Enumeration date
04/27/2021
Last updated
04/27/2021
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