Organization
RIDGEFIELD ORAL AND MAXILLOFACIAL SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN EDWARD SMULLIN DMD, MD (OWNER)
(203) 403-3686
Entity
Organization
Contact information
Practice address
10 SOUTH ST STE 202, RIDGEFIELD, CT 06877-4125
(203) 403-3686
Mailing address
87 BROOKHOLLOW LN, STAMFORD, CT 06902-1014
(617) 230-1152
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
03/14/2019
Last updated
03/14/2019
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