Organization
ELYASSI'S GREENBELT ORAL AND FACIAL SURGERY
Active
Organization
ELYASSI'S GREENBELT ORAL AND FACIAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALI R. ELYASSI DDS (OWNER)
(301) 982-4555
Entity
Organization
Contact information
Practice address
7525 GREENWAY CENTER DR, SUITE 109, GREENBELT, MD 20770-3509
(301) 982-4555
(301) 982-4557
Mailing address
7525 GREENWAY CENTER DR, SUITE 109, GREENBELT, MD 20770-3509
(301) 982-4555
(301) 982-4557
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1447235940
NPI
MD
Enumeration date
11/09/2015
Last updated
11/09/2015
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