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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