Organization
GLEN BURNIE ORAL SURGERY ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMAN SOURI DMD (PRESIDENT)
(917) 701-3581
Entity
Organization
Contact information
Practice address
300 HOSPITAL DR, # 237, GLEN BURNIE, MD 21061-6902
(917) 701-3581
Mailing address
2523 SMITH AVE, BALTIMORE, MD 21209-2542
(917) 701-3581
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
16083
MD
Other
Enumeration date
11/27/2015
Last updated
11/27/2015
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