Organization
MARYLAND ORAL SURGERY ASSOCIATES, LLC
Active
Other names
Maryland Oral Surgery Associates Crofton, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLENN A. NATHAN D.D.S. (PRESIDENT)
(301) 340-6884
Entity
Organization
Contact information
Practice address
2401 BRANDERMILL BLVD., SUITE 320, GAMBRILLS, MD 21054
(410) 721-0700
(410) 721-5459
Mailing address
14955 SHADY GROVE ROAD, SUITE 350, ROCKVILLE, MD 20850-8700
(301) 340-6884
(301) 340-3836
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
12859
MD
Other
Enumeration date
01/07/2014
Last updated
08/08/2023
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