| Potomac Oral And Maxillofacial Surgery; Llc | |
|
3150 W Ward Rd Ste 306 Dunkirk MD 20754-3057 | |
| (615) 585-9364 | |
| (410) 257-2842 |
| Full Name | Potomac Oral And Maxillofacial Surgery; Llc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 3150 W Ward Rd Ste 306, Dunkirk, Maryland |
| Authorized Official Name and Position | Wendell Gardner (ORAL AND MAXILLOFACIAL SURGEON) |
| Authorized Official Contact | 6155859364 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Potomac Oral And Maxillofacial Surgery; Llc 3150 W Ward Rd Ste 306 Dunkirk MD 20754-3057 Ph: (410) 257-5333 | Potomac Oral And Maxillofacial Surgery; Llc 3150 W Ward Rd Ste 306 Dunkirk MD 20754-3057 Ph: (615) 585-9364 |
| NPI Number | 1972202711 |
|---|---|
| Provider Enumeration Date | 03/01/2023 |
| Last Update Date | 03/01/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972202711 | NPI | - | NPPES |
| 1942407812 | Medicaid | PA | |
| 1679626881 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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