Organization
LOUIS V. THEODOS, DMD ORAL AND MAXILLOFACIAL SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOUIS VINCENT THEODOS DMD (OWNER/SOLE PROPRIETOR)
(203) 790-6288
Entity
Organization
Contact information
Practice address
52 FEDERAL RD, SUITE 2A, DANBURY, CT 06810-6162
(203) 790-6288
(203) 790-7617
Mailing address
52 FEDERAL RD, SUITE 2A, DANBURY, CT 06810-6162
(203) 790-6288
(203) 790-7617
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
7113
CT
Other
Enumeration date
06/03/2014
Last updated
02/27/2015
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