Organization
KING ORAL SURGERY GROUP
Active
Other names
n/a
Organization subpart
No
Provider details
NPI number
Authorized official
MICHEAL KING (PRESIDENT)
(615) 293-3744
Entity
Organization
Contact information
Practice address
11885 HOLLY LN STE 2, WALDORF, MD 20601-3187
(301) 645-4555
Mailing address
6368 COVENTRY WAY STE 197, CLINTON, MD 20735-2256
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
14203
MD
Other
Enumeration date
11/17/2010
Last updated
11/17/2010
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