Organization
MANCHESTER ORAL AND IMPLANT SURGERY PLLC
Active
Other names
Rosenlicht Oral Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
LISA HARRISON (MANAGER)
(860) 649-2272
Entity
Organization
Contact information
Practice address
483 MIDDLE TURNPIKE WEST, SUITE 102, MANCHESTER, CT 06040-3863
(860) 649-2272
(860) 649-4538
Mailing address
483 MIDDLE TPKE W, SUITE 102, MANCHESTER, CT 06040-3863
(860) 649-2272
(860) 649-4538
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
TCONTROLL2454
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
061050677
TAX ID
CT
Enumeration date
11/10/2008
Last updated
09/04/2025
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