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Organization
RIDGEFIELD ORAL AND MAXILLOFACIAL SURGERY, LLC
Active
Organization
RIDGEFIELD ORAL AND MAXILLOFACIAL SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN EDWARD SMULLIN DMD, MD (OWNER)
(203) 403-3686
Entity
Organization
Contact information
Practice address
10 SOUTH ST STE 202, RIDGEFIELD, CT 06877-4125
(203) 403-3686
Mailing address
87 BROOKHOLLOW LN, STAMFORD, CT 06902-1014
(617) 230-1152
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
03/14/2019
Last updated
03/14/2019
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