Organization
MID-MARYLAND ORAL AND MAXILLOFACIAL SURGERY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER M TAN DDS MSHS (PRESIDENT)
(301) 694-2300
Entity
Organization
Contact information
Practice address
68 THOMAS JOHNSON DR, SUITE A, FREDERICK, MD 21702
(301) 694-2300
(301) 694-7372
Mailing address
68 THOMAS JOHNSON DR, SUITE A, FREDERICK, MD 21702
(301) 694-2300
(301) 694-7372
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
—
—
Other
Enumeration date
02/13/2006
Last updated
07/21/2010
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