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General NPI Number Information
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NPI Number | 1245742741
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Entity Type | Organization
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Legal Business Name | AKESO ORAFACIAL MAXILLARY SURGERY
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Dates
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Enumeration Date | 10/25/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 7544 BELAIR ROAD
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City | NOTTINGHAM
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State | MD
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Zip | 21236
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Country | US
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Telephone | 410-665-2500
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Fax | 410-665-3235
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Provider Business Mailing Address
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Address Line | 7544 BELAIR RD
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City | NOTTINGHAM
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State | MD
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Zip | 21236-4108
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Country | US
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Telephone | 410-665-2500
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Fax | 410-665-3235
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Authorized Official
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Title or Position | OWNER/ORAL SURGEON
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Name | DR. TREVANN LYN
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Credential | DMD
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Telephone | 410-665-2500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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