| Columbia Oral And Facial Surgery Center, Llc | |
|
10782 Hickory Ridge Rd Columbia MD 21044-3646 | |
| (410) 730-6001 | |
| Not Available |
| Full Name | Columbia Oral And Facial Surgery Center, Llc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 10782 Hickory Ridge Rd, Columbia, Maryland |
| Authorized Official Name and Position | Nick H. Wang (PRESIDENT) |
| Authorized Official Contact | 4107306001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Columbia Oral And Facial Surgery Center, Llc 10782 Hickory Ridge Rd Columbia MD 21044-3646 Ph: (410) 730-6001 | Columbia Oral And Facial Surgery Center, Llc 10782 Hickory Ridge Rd Columbia MD 21044-3646 Ph: (410) 730-6001 |
| NPI Number | 1598164055 |
|---|---|
| Provider Enumeration Date | 08/20/2014 |
| Last Update Date | 08/20/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598164055 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 14992 (Maryland) | Primary |
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