Organization
CONNECTICUT MAXILLOFACIAL SURGEONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCHANTAL MARY THIELKE RDA (BILLING & INSURANCE MANAGER)
(860) 678-7528
Entity
Organization
Contact information
Practice address
291 FARMINGTON AVE, FARMINGTON, CT 06032-1925
(860) 678-7528
(860) 678-7933
Mailing address
291 FARMINGTON AVE, FARMINGTON, CT 06032-1925
(860) 678-7528
(860) 678-7933
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
07/16/2006
Last updated
07/21/2025
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