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Organization

EAST LYME ORAL AND MAXILLOFACIAL SURGERY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KIRK FRED ENGEL DMD (MEMBER AND OWNER)
(860) 739-3133
Entity
Organization

Contact information

Practice address
314 FLANDERS RD, SUITE 1B, EAST LYME, CT 06333-1727
(860) 739-3133
(860) 739-3131
Mailing address
314 FLANDERS RD, SUITE 1B, EAST LYME, CT 06333-1727
(860) 739-3133
(860) 739-3131

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
007384
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1659376507
NPI FOR DR. KIRK ENGEL
CT
Enumeration date
11/08/2006
Last updated
08/25/2007
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