Organization
COVENTRY ORAL AND IMPLANT SURGERY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAZ ANSARI DDS (OWNER)
(860) 649-2272
Entity
Organization
Contact information
Practice address
1572 BOSTON TPKE, COVENTRY, CT 06238-1205
(860) 649-2272
Mailing address
483 MIDDLE TPKE W STE 102, MANCHESTER, CT 06040-3864
(860) 649-2272
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
05/02/2023
Last updated
05/02/2023
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