Organization
MARYLAND ORAL SURGERY ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAUREEN PETERSEN (OPERATIONS MANAGER)
(301) 340-6884
Entity
Organization
Contact information
Practice address
1667 CROFTON CTR, SUITE 7A, CROFTON, MD 21114-1303
(410) 721-0700
(410) 721-5459
Mailing address
14955 SHADY GROVE RD, SUITE 330, ROCKVILLE, MD 20850-8700
(301) 340-6884
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
12859
MD
Other
Enumeration date
04/25/2008
Last updated
06/25/2008
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