# GREENWICH ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073633426
- **Authorized official:** DR. STEVEN M BRODY DDS (PRESIDENT)
- **Authorized official phone:** (203) 661-5858

## Contact information

- **Practice address:** 23 MAPLE AVE, GREENWICH, CT 06830-5620
- **Practice address phone:** (203) 661-5858
- **Practice address fax:** (203) 661-1159
- **Mailing address:** 23 MAPLE AVE, GREENWICH, CT 06830-5620
- **Mailing address phone:** (203) 661-5858
- **Mailing address fax:** (203) 661-1159

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 009552 | CT | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 033181 | NY | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 040760 | NY | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 049719-1 | NY | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 6237 | CT | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 7023 | CT | — |

## Other

- **Enumeration date:** 03/30/2007
- **Last updated:** 08/22/2020