Organization
CENTER FOR ORAL AND IMPLANT SURGERY OF GREENWICH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHELE S. BERGEN DMD, MD (PARTNER)
(203) 661-4231
Entity
Organization
Contact information
Practice address
49 LAKE AVE, GREENWICH, CT 06830-4501
(203) 661-4231
(203) 661-0155
Mailing address
49 LAKE AVE, GREENWICH, CT 06830-4501
(203) 661-4231
(203) 661-0155
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
—
—
Other
Enumeration date
12/04/2009
Last updated
01/19/2010
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