Organization
MARYLAND ORAL SURGERY ASSOCIATES, LLC
Active
Other names
Maryland Oral Surgery Associates of Frederick, 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
161 THOMAS JOHNSON DR STE 295, FREDERICK, MD 21702-4314
(301) 698-5208
(301) 698-1848
Mailing address
14955 SHADY GROVE RD., SUITE 350, ROCKVILLE, MD 20850
(301) 340-6884
(301) 340-3836
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
11347
MD
Other
Enumeration date
03/12/2014
Last updated
08/08/2023
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