Organization
ORAL SURGERY ASSOCIATES, L.L.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STACEY L WHELAN (INSURANCE COORDINATOR)
(203) 371-5595
Entity
Organization
Contact information
Practice address
4747 MAIN ST, BRIDGEPORT, CT 06606-1804
(203) 371-5595
Mailing address
4747 MAIN STREET, BRIDGEPORT, CT 06606
(203) 371-5595
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
4982
CT
Other
Enumeration date
08/09/2006
Last updated
10/01/2007
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