# EAST LYME ORAL AND MAXILLOFACIAL SURGERY

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

## Provider details

- **NPI number:** 1205906369
- **Authorized official:** DR. KIRK FRED ENGEL DMD (MEMBER AND OWNER)
- **Authorized official phone:** (860) 739-3133

## Contact information

- **Practice address:** 314 FLANDERS RD, SUITE 1B, EAST LYME, CT 06333-1727
- **Practice address phone:** (860) 739-3133
- **Practice address fax:** (860) 739-3131
- **Mailing address:** 314 FLANDERS RD, SUITE 1B, EAST LYME, CT 06333-1727
- **Mailing address phone:** (860) 739-3133
- **Mailing address fax:** (860) 739-3131

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 007384 | CT | Yes |

## Other

- **Enumeration date:** 11/08/2006
- **Last updated:** 08/25/2007