Organization
CENTER FOR ORAL AND MAXILLOFACIAL RECONSTRUCTIVE SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALI PASHAPOUR (PRESIDENT)
(973) 223-2678
Entity
Organization
Contact information
Practice address
3001 HOSPITAL DR, CHEVERLY, MD 20785-1189
(973) 223-2678
Mailing address
3700 MASSACHUSETTS AVE NW, SUITE 116, WASHINGTON, DC 20016-5800
(973) 223-2678
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
0401411854
VA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
14010
MD
Other
Enumeration date
10/25/2010
Last updated
02/24/2012
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