| Evolution Oral Surgery | |
|
19851 Observation Dr Ste 320 Germantown MD 20876-4143 | |
| (301) 916-6000 | |
| (301) 916-6113 |
| Full Name | Evolution Oral Surgery |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Pathology |
| Location | 19851 Observation Dr Ste 320, Germantown, Maryland |
| Authorized Official Name and Position | James Ryan (ORAL SURGEON/OWNER) |
| Authorized Official Contact | 3019166000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evolution Oral Surgery 19851 Observation Dr Ste 320 Germantown MD 20876-4143 Ph: (301) 916-6000 | Evolution Oral Surgery 19851 Observation Dr Ste 320 Germantown MD 20876-4143 Ph: (301) 916-6000 |
| NPI Number | 1821693300 |
|---|---|
| Provider Enumeration Date | 12/02/2020 |
| Last Update Date | 12/07/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821693300 | NPI | - | NPPES |
| 1356508493 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0106X | Dentist - Oral And Maxillofacial Pathology | (* (Not Available)) | Primary |
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