Organization
MANCHESTER ORAL AND IMPLANT SURGERY PLLC
Active
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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