# NEW HAVEN IMPLANT AND ORAL SURGERY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Connecticut Implant and Oral Surgery Specialists, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992109656
- **Authorized official:** DR. JORDAN GREENBERG D.D.S. (MEMBER/PRESIDENT)
- **Authorized official phone:** (914) 355-0840

## Contact information

- **Practice address:** 1423 CHAPEL ST, UNIT 3C, NEW HAVEN, CT 06511-4411
- **Practice address phone:** (203) 787-6581
- **Mailing address:** 1423 CHAPEL ST, UNIT 3C, NEW HAVEN, CT 06511-4411
- **Mailing address phone:** (203) 787-6581

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 10/09/2014
- **Last updated:** 10/22/2014