Organization
ORAL PATHOLOGY SERVICES/MARYLAND ORAL DIAGNOSIS AND THERAPEUTICS, LLC
Active
Other names
Oral Pathology Services
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DI SUN DDS PHD (DIRECTOR)
(301) 869-8666
Entity
Organization
Contact information
Practice address
610 PROFESSIONAL DR STE 215, GAITHERSBURG, MD 20879-3439
(301) 869-8666
(301) 869-8677
Mailing address
50 W EDMONSTON DR, SUITE 402, ROCKVILLE, MD 20852-1228
(301) 838-9033
(301) 838-9148
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
11508
MD
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
11508
MD
1223P0106X
Oral and Maxillofacial Pathology Dentistry
5326
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5486025
—
MD
Enumeration date
03/31/2008
Last updated
04/03/2023
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