Organization
COLUMBIA ORAL MAXILLOFACIAL IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BIBI KHAN (PRACTICE MANAGER)
(860) 645-0111
Entity
Organization
Contact information
Practice address
483 MIDDLE TPKE W, MANCHESTER, CT 06040-3863
(860) 645-0111
Mailing address
483 MIDDLE TPKE W, MANCHESTER, CT 06040-3863
(860) 645-0111
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223P0300X
Periodontics
—
—
Other
Enumeration date
04/02/2007
Last updated
09/20/2012
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