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Organization
UNIVERSITY DENTISTS
Active
Organization
UNIVERSITY DENTISTS
Active
Other names
Oral Maxillofacial Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
ELLIE ATKINS (CREDENTIALING CONTACT)
(860) 679-2207
Entity
Organization
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-0001
(860) 679-8156
(860) 679-1159
Mailing address
263 FARMINGTON AVE, FARMINGTON, CT 06030-3905
(860) 679-2207
(860) 679-1899
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
05/07/2018
Last updated
05/08/2026
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