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General NPI Number Information
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NPI Number | 1518298462
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Entity Type | Organization
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Legal Business Name | CENTRAL MARYLAND ORAL AND MAXILLOFACIAL SURGERY, P. A.
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Dates
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Enumeration Date | 01/15/2010
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Last Update Date | 06/22/2010
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Provider Practice Location Address
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Address Line | 10710 CHARTER DR SUITE 330
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City | COLUMBIA
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State | MD
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Zip | 21044-3128
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Country | US
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Telephone | 410-997-1010
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Fax | 410-997-0807
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Provider Business Mailing Address
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Address Line | 10710 CHARTER DR SUITE 330
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City | COLUMBIA
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State | MD
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Zip | 21044-3128
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Country | US
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Telephone | 410-997-1010
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Fax | 410-997-0807
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD JOSEPH NESSIF
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Credential | D. D. S.
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Telephone | 410-997-1010
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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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