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Organization

MD OMS SDS, LLC

Active
Parent organization
MD OMS SDS, LLC
Other names
GermanTown Oral And Facial Surgery Center, Columbia Oral and Facial Surgery Center
Organization subpart
Yes

Provider details

NPI number
Legal business name
MD OMS SDS, LLC
Authorized official
CHARLOTTE DASCH (DIREC OF CRED AND PROV REL)
(504) 638-0303
Entity
Organization

Contact information

Practice address
19717 EXECUTIVE PARK CIR, GERMANTOWN, MD 20874-2639
(301) 916-0486
Mailing address
1610 54TH AVE N STE 205, NASHVILLE, TN 37209-1442
(615) 678-0759

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary

Other

Enumeration date
05/29/2024
Last updated
05/29/2024
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