Organization
FREDERICKTOWN AMBULATORY SURGICAL FACILITY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VINCENT EDWIN DIFABIO D.D.S. (PRESEIDENT)
30169040870
Entity
Organization
Contact information
Practice address
198 THOMAS JOHNSON DR, SUITE 101, FREDERICK, MD 21702-4398
(301) 694-0870
(301) 694-7034
Mailing address
198 THOMAS JOHNSON DR, SUITE 101, FREDERICK, MD 21702-4398
(301) 694-0870
(301) 694-7034
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
A1166
MD
Other
Enumeration date
01/24/2007
Last updated
08/22/2020
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