# CONNECTICUT ORAL & MAXILLOFACIAL SURGERY CENTERS, LLC

> 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
- **Parent organization:** CONNECTICUT ORAL & MAXILLOFACIAL SURGERY CENTERS, LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1558272237
- **Legal business name:** CONNECTICUT ORAL & MAXILLOFACIAL SURGERY CENTERS, LLC
- **Authorized official:** MICHAELA MUNIZ (VP, PAYOR RELATIONS)
- **Authorized official phone:** (469) 324-3242

## Contact information

- **Practice address:** 10 HIGGINS HWY STE 10, MANSFIELD CENTER, CT 06250-1486
- **Practice address phone:** (860) 423-2587
- **Mailing address:** 10 HIGGINS HWY STE 10, MANSFIELD CENTER, CT 06250-1486
- **Mailing address phone:** (860) 423-2587

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | NULL | — |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | — | — |

## Other

- **Enumeration date:** 09/14/2026
- **Last updated:** 09/14/2026