| Central Maryland Oral And Maxillofacial Surgery, P. A. | |
|
10710 Charter Dr Suite 330 Columbia MD 21044-3128 | |
| (410) 997-1010 | |
| (410) 997-0807 |
| Full Name | Central Maryland Oral And Maxillofacial Surgery, P. A. |
|---|---|
| Speciality | Dentist |
| Location | 10710 Charter Dr, Columbia, Maryland |
| Authorized Official Name and Position | Richard Joseph Nessif (PRESIDENT) |
| Authorized Official Contact | 4109971010 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Maryland Oral And Maxillofacial Surgery, P. A. 10710 Charter Dr Suite 330 Columbia MD 21044-3128 Ph: (410) 997-1010 | Central Maryland Oral And Maxillofacial Surgery, P. A. 10710 Charter Dr Suite 330 Columbia MD 21044-3128 Ph: (410) 997-1010 |
| NPI Number | 1518298462 |
|---|---|
| Provider Enumeration Date | 01/15/2010 |
| Last Update Date | 06/22/2010 |
| Medicare PECOS PAC ID | 4385771195 |
|---|---|
| Medicare Enrollment ID | O20100428000300 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518298462 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Domenick P Coletti |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1720071236 PECOS PAC ID: 7618948621 Enrollment ID: I20040803001676 |
| Provider Name | Richard J Nessif |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1497086342 PECOS PAC ID: 5092861096 Enrollment ID: I20100428000619 |
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