| The Maryland Oral Surgery Group and Implant Center of Bowie | |
|
14300 Gallant Fox Ln Ste 220 Bowie MD 20715-4033 | |
| (301) 967-0183 | |
| (301) 576-5800 |
| Full Name | The Maryland Oral Surgery Group and Implant Center of Bowie |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 14300 Gallant Fox Ln Ste 220, Bowie, Maryland |
| Authorized Official Name and Position | Mark Russell (OPERATIONS MANAGER) |
| Authorized Official Contact | 3019670183 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Maryland Oral Surgery Group and Implant Center of Bowie 9632 Marlboro Pike Upper Marlboro MD 20772-3767 Ph: (301) 967-0183 | The Maryland Oral Surgery Group and Implant Center of Bowie 14300 Gallant Fox Ln Ste 220 Bowie MD 20715-4033 Ph: (301) 967-0183 |
| NPI Number | 1114629334 |
|---|---|
| Provider Enumeration Date | 03/21/2023 |
| Last Update Date | 03/21/2023 |
| Certification Date | 03/21/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114629334 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | () | Primary |
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