| Oral And Maxillofacial Surgery Specialists Pc | |
|
10215 Fernwood Rd Suite 510 Bethesda MD 20817-1106 | |
| (301) 564-1400 | |
| (301) 564-1413 |
| Full Name | Oral And Maxillofacial Surgery Specialists Pc |
|---|---|
| Speciality | Dentist |
| Location | 10215 Fernwood Rd, Bethesda, Maryland |
| Authorized Official Name and Position | George Grillon (PRESIDENT) |
| Authorized Official Contact | 3015641400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oral And Maxillofacial Surgery Specialists Pc 10215 Fernwood Rd Suite 510 Bethesda MD 20817-1106 Ph: (301) 564-1400 | Oral And Maxillofacial Surgery Specialists Pc 10215 Fernwood Rd Suite 510 Bethesda MD 20817-1106 Ph: (301) 564-1400 |
| NPI Number | 1164548335 |
|---|---|
| Provider Enumeration Date | 03/21/2007 |
| Last Update Date | 02/02/2011 |
| Medicare PECOS PAC ID | 0840480646 |
|---|---|
| Medicare Enrollment ID | O20120521000228 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164548335 | NPI | - | NPPES |
| 115951800 | Medicaid | MD | |
| 6374780001 | Other | MD | P10 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | George Louis Grillon |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1134271711 PECOS PAC ID: 0143483636 Enrollment ID: I20120521000243 |
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