| NPI | 1629595145 |
|---|---|
| Doing Business As | EAST OF THE RIVER ORAL AND MAXILLOFACIAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | GARY TODD FISHBEIN Oral And Maxillofacial Surgeon 860-872-8331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CT 11333) |
| Enumeration Date | 2017-08-25 |
| Last Update Date | 2017-08-25 |