Organization
FAIRFIELD OMS LLC
Active
Other names
Fairfield Oral Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD HENDRICKS (CREDENTIALING)
(612) 859-0444
Entity
Organization
Contact information
Practice address
760 KINGS HWY W BLDG B, SOUTHPORT, CT 06890-3102
(203) 259-2227
Mailing address
760 KINGS HWY W BLDG B, SOUTHPORT, CT 06890-3102
(203) 259-2227
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
07/23/2025
Last updated
07/23/2025
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