Individual
DR. PETER M TAN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2480 LLEWELLYN AVE, FORT GEORGE G MEADE, MD 20755-7081
(301) 677-8956
Mailing address
1553 HUGO CIR, SILVER SPRING, MD 20906-5918
(301) 639-2536
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
15999
MD
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
4367
WV
Other
Enumeration date
08/03/2015
Last updated
06/13/2022
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