| Oral Pathology Services/maryland Oral Diagnosis And Therapeutics, Llc | |
|
610 Professional Dr Ste 215 Gaithersburg MD 20879-3439 | |
| (301) 869-8666 | |
| (301) 869-8677 |
| Full Name | Oral Pathology Services/maryland Oral Diagnosis And Therapeutics, Llc |
|---|---|
| Speciality | Dentist |
| Location | 610 Professional Dr Ste 215, Gaithersburg, Maryland |
| Authorized Official Name and Position | Di Sun (DIRECTOR) |
| Authorized Official Contact | 3018698666 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oral Pathology Services/maryland Oral Diagnosis And Therapeutics, Llc 50 W Edmonston Dr Suite 402 Rockville MD 20852-1228 Ph: (301) 838-9033 | Oral Pathology Services/maryland Oral Diagnosis And Therapeutics, Llc 610 Professional Dr Ste 215 Gaithersburg MD 20879-3439 Ph: (301) 869-8666 |
| NPI Number | 1760654784 |
|---|---|
| Provider Enumeration Date | 03/31/2008 |
| Last Update Date | 04/03/2023 |
| Medicare PECOS PAC ID | 4880742170 |
|---|---|
| Medicare Enrollment ID | O20090424000086 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760654784 | NPI | - | NPPES |
| 5486025 | Medicaid | MD |
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