| NPI | 1407455538 |
|---|---|
| Former Legal Business Name | GLASTONBURY IMPLANT DENTISTRY, ORAL AND FACIAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | RYAZ ANSARI Owner/Oms 860-649-0227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology |
| Enumeration Date | 2020-10-20 |
| Last Update Date | 2025-06-16 |