Organization
STAMFORD ORAL AND MAXILLOFACIAL SURGICAL ARTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NAUSHAD EDIBAM (MEMBER)
(203) 325-2661
Entity
Organization
Contact information
Practice address
27 BRIDGE ST, STAMFORD, CT 06905-4501
(203) 325-2661
Mailing address
27 BRIDGE ST, STAMFORD, CT 06905-4501
(203) 325-2661
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
009711
CT
Other
Enumeration date
11/04/2016
Last updated
11/04/2016
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