Organization
ORAL MAXILLOFACIAL SURGERY FAIRFIELD COUNTY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IMANUEL BABAYEV DDS, MD (OWNER)
(718) 666-6664
Entity
Organization
Contact information
Practice address
148 EAST AVE STE 3H1, NORWALK, CT 06851-5721
(718) 666-6664
Mailing address
148 EAST AVE STE 3H1, NORWALK, CT 06851-5721
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
12/22/2016
Last updated
12/22/2016
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