# CROMPTON PARK ORAL SURGERY AND IMPLANT ASSOCIATES, LLP

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1093998387
- **Authorized official:** W DAVID KELLY DMD (MEMBER)
- **Authorized official phone:** (508) 799-2550

## Contact information

- **Practice address:** 59 QUINSIGAMOND AVE, WORCESTER, MA 01610-1806
- **Practice address phone:** (508) 799-2550
- **Mailing address:** 59 QUINSIGAMOND AVE, WORCESTER, MA 01610-1806
- **Mailing address phone:** (508) 799-2550

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 12222 | MA | Yes |

## Other

- **Enumeration date:** 12/10/2007
- **Last updated:** 12/10/2007