# CONNECTICUT VALLEY ORAL SURGERY ASSOCIATES, PC

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

## Provider details

- **NPI number:** 1558382572
- **Authorized official:** CANDY EBBIGHAUSEN (ADMINISTRATOR)
- **Authorized official phone:** (603) 357-3709

## Contact information

- **Practice address:** 243 KING ST, SUITE 101, NORTHAMPTON, MA 01060-2451
- **Practice address phone:** (413) 585-0002
- **Practice address fax:** (413) 584-9583
- **Mailing address:** 243 KING ST, STE 101, NORTHAMPTON, MA 01060
- **Mailing address phone:** (413) 585-0002
- **Mailing address fax:** (413) 584-9583

## Taxonomy

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

## Other

- **Enumeration date:** 07/23/2006
- **Last updated:** 12/15/2022