Organization
WASHINGTON ORAL SURGERY CENTER, LLC
Active
Organization
WASHINGTON ORAL SURGERY CENTER, LLC
Active
Other names
Woodview Oral Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKO NKUNGULA (FINANCE MANAGER)
(301) 341-0041
Entity
Organization
Contact information
Practice address
1401 MERCANTILE LN, SUITE 102, LARGO, MD 20774-4301
(301) 341-0041
Mailing address
1401 MERCANTILE LN, SUITE 102, LARGO, MD 20774-4301
(301) 341-0041
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
14426
MD
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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