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Organization
FAIRFIELD ORAL SURGERY, LLC
Active
Organization
FAIRFIELD ORAL SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TODD EVAN BLOOM M.S., D.D.S. (PRESIDENT)
(203) 259-2227
Entity
Organization
Contact information
Practice address
1305 POST RD, SUITE 303, FAIRFIELD, CT 06824-6016
(203) 259-2227
(203) 259-2218
Mailing address
1305 POST RD, SUITE 303, FAIRFIELD, CT 06824-6016
(203) 259-2227
(203) 259-2218
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
9276
CT
Other
Enumeration date
06/03/2006
Last updated
12/19/2007
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