Organization
GREENWICH ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN M BRODY DDS (PRESIDENT)
(203) 661-5858
Entity
Organization
Contact information
Practice address
23 MAPLE AVE, GREENWICH, CT 06830-5620
(203) 661-5858
(203) 661-1159
Mailing address
23 MAPLE AVE, GREENWICH, CT 06830-5620
(203) 661-5858
(203) 661-1159
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
009552
CT
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
033181
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
040760
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
049719-1
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
6237
CT
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
7023
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1518057389
NPI
CT
01
—
1649298944
NPI
CT
01
—
NPI
1255421012
—
Enumeration date
03/30/2007
Last updated
08/22/2020
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