Organization
SUNRISE ORAL SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAX MCCUSKER (AUTHORIZED OFFICIAL)
(949) 521-2757
Entity
Organization
Contact information
Practice address
16069 COMPRINT CIR, GAITHERSBURG, MD 20877-1321
(301) 762-0062
(301) 762-9110
Mailing address
285 W 530 N, VINEYARD, UT 84059-4817
(949) 521-2757
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
02/27/2024
Last updated
02/29/2024
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