Organization
MARYLAND ORAL SURGERY ASSOCIATES, LLC
Active
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
128 LUBRANO DRIVE, SUITE 300, ANNAPOLIS, MD 21401-7028
(410) 897-0111
(410) 897-0110
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
—
MD
Other
Enumeration date
06/03/2014
Last updated
08/08/2023
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