Organization
ORAL SURGERY OF MARYLAND, LLC JEROME CASPER SOLE MBR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA PERKINS (ONBOARDING SPECIALIST)
(678) 244-4844
Entity
Organization
Contact information
Practice address
13600 BALTIMORE AVE STE 200, LAUREL, MD 20707-9495
(770) 692-1000
Mailing address
PO BOX 14701, SAINT LOUIS, MO 63178-4701
(770) 692-1000
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
04/27/2021
Last updated
04/27/2021
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