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Organization
COVENTRY ORAL AND IMPLANT SURGERY PLLC
Active
Organization
COVENTRY ORAL AND IMPLANT SURGERY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAZ ANSARI DDS (OWNER)
(860) 649-2272
Entity
Organization
Contact information
Practice address
1572 BOSTON TPKE, COVENTRY, CT 06238-1205
(860) 649-2272
Mailing address
483 MIDDLE TPKE W STE 102, MANCHESTER, CT 06040-3864
(860) 649-2272
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
05/02/2023
Last updated
05/02/2023
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