| The Maryland Oral Surgery Group | |
|
9632 Pennsylvania Ave Upper Marlboro MD 20772-3670 | |
| (240) 478-7030 | |
| Not Available |
| Full Name | The Maryland Oral Surgery Group |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 9632 Pennsylvania Ave, Upper Marlboro, Maryland |
| Authorized Official Name and Position | Sharon Sherise Russell (ORAL SURGEON) |
| Authorized Official Contact | 2404787030 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Maryland Oral Surgery Group 3305 Old Largo Rd Upper Marlboro MD 20772-7811 Ph: (240) 478-7030 | The Maryland Oral Surgery Group 9632 Pennsylvania Ave Upper Marlboro MD 20772-3670 Ph: (240) 478-7030 |
| NPI Number | 1689930919 |
|---|---|
| Provider Enumeration Date | 04/11/2012 |
| Last Update Date | 04/11/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689930919 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 14351 (Maryland) | Primary |
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