Provider Demographics
NPI:1184866006
Name:HUNT VALLEY ORAL SURGERY, P.A.
Entity type:Organization
Organization Name:HUNT VALLEY ORAL SURGERY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:D
Authorized Official - Last Name:ZASLOW
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-472-9050
Mailing Address - Street 1:10 FILA WAY
Mailing Address - Street 2:SUITE 201B
Mailing Address - City:SPARKS
Mailing Address - State:MD
Mailing Address - Zip Code:21152-9452
Mailing Address - Country:US
Mailing Address - Phone:410-472-9050
Mailing Address - Fax:
Practice Address - Street 1:10 FILA WAY
Practice Address - Street 2:SUITE 201B
Practice Address - City:SPARKS
Practice Address - State:MD
Practice Address - Zip Code:21152-9452
Practice Address - Country:US
Practice Address - Phone:410-472-9050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-25
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD125501223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty