Organization
HARTFORD COUNTY ORAL MAXILLOFACIAL & IMPLANT SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EAN JAMES D.M.D., M.D (PRESIDENT)
(856) 361-6703
Entity
Organization
Contact information
Practice address
259 FARMINGTON AVE, SUITE 1, BRISTOL, CT 06010-3969
(860) 583-6549
(860) 582-1547
Mailing address
259 FARMINGTON AVE, SUITE 1, BRISTOL, CT 06010-3969
(860) 583-6549
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
10729
CT
Other
Enumeration date
03/12/2013
Last updated
03/12/2013
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