Organization
MARYLAND ORAL SURGERY ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLENN A. NATHAN D.D.S. (PRESIDENT)
(301) 340-6884
Entity
Organization
Contact information
Practice address
1300 SPRING ST STE 350, SILVER SPRING, MD 20910-3851
(301) 593-8077
(301) 593-9196
Mailing address
14955 SHADY GROVE ROAD, SUITE 350, ROCKVILLE, MD 20850-8700
(301) 340-6884
(301) 340-3836
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
12859
MD
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
14075
MD
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
9161
MD
Other
Enumeration date
05/07/2012
Last updated
04/17/2024
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