Organization
DEREK C. EGO-OSUALA LLC
Active
Other names
Excelsis root canal specialties
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEREK EGO-OSUALA DDS, MS (ENDODONTIST)
(240) 244-1013
Entity
Organization
Contact information
Practice address
7700 OLD BRANCH AVENUE, A-204, CLINTON, MD 20735
(240) 244-1013
(240) 244-1035
Mailing address
7700 OLD BRANCH AVE, A-204, CLINTON, MD 20735-1628
(240) 244-1013
(240) 244-1035
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
14162
MD
Other
Enumeration date
01/21/2011
Last updated
01/31/2013
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