Organization
CONNECTICUT CENTER FOR ORAL FACIAL AND IMPLANT SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACOB MARSHALL GADY D.M.D., M.D. (PRESIDENT)
(860) 231-1030
Entity
Organization
Contact information
Practice address
80 S MAIN ST, WEST HARTFORD, CT 06107-2408
(860) 231-1030
(860) 231-1032
Mailing address
80 S MAIN ST, WEST HARTFORD, CT 06107-2408
(860) 231-1030
(860) 231-1032
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
011331
CT
Other
Enumeration date
10/16/2015
Last updated
10/17/2022
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