# NEW: GLASTONBURY ORAL AND IMPLANT SURGERY PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Glastonbury Implant Dentistry, Oral and Facial Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407455538
- **Authorized official:** DR. RYAZ ANSARI D.D.S. (OWNER/OMS)
- **Authorized official phone:** (860) 649-0227

## Contact information

- **Practice address:** 131 NEW LONDON TURNPIKE, GLASTONBURY, CT 06033-7042
- **Practice address phone:** (860) 659-2623
- **Mailing address:** 483 MIDDLE TPKE W STE 102, MANCHESTER, CT 06040-3864
- **Mailing address phone:** (860) 649-2272
- **Mailing address fax:** (860) 533-1010

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0106X | Oral and Maxillofacial Pathology Dentistry | — | NULL | Yes |
| 1223P0106X | Oral and Maxillofacial Pathology Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 10/20/2020
- **Last updated:** 06/16/2025