| NPI | 1881183721 |
|---|---|
| Other Name | ORAL MAXILLOFACIAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | ELLIE ATKINS Credentialing Contact 860-679-2207 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2018-05-07 |
| Last Update Date | 2018-05-07 |