| Akeso Orofacial Surgery, Llc | |
|
13934 Baltimore Ave Laurel MD 20707-5000 | |
| (301) 329-5758 | |
| (410) 665-3235 |
| Full Name | Akeso Orofacial Surgery, Llc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 13934 Baltimore Ave, Laurel, Maryland |
| Authorized Official Name and Position | Trevann Lyn (OWNER) |
| Authorized Official Contact | 3013295758 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Akeso Orofacial Surgery, Llc 13934 Baltimore Ave Laurel MD 20707-5000 Ph: (301) 329-5758 | Akeso Orofacial Surgery, Llc 13934 Baltimore Ave Laurel MD 20707-5000 Ph: (301) 329-5758 |
| NPI Number | 1457913907 |
|---|---|
| Provider Enumeration Date | 07/05/2019 |
| Last Update Date | 07/05/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457913907 | NPI | - | NPPES |
| 58463100 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| 261QS0112X | Clinic/center - Oral And Maxillofacial Surgery | (* (Not Available)) | Secondary |
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