Organization
MOFS-CT ORAL FACIAL SURGERY LLC
Active
Other names
Dental Oral Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JANET C BODEY DDS (MANAGING MEMBER)
(203) 998-7470
Entity
Organization
Contact information
Practice address
1 BOULDER AVE, OLD GREENWICH, CT 06870-1420
(203) 990-3300
(212) 202-6447
Mailing address
6118 RIVERDALE AVE, BRONX, NY 10471-1009
(203) 998-7470
(212) 202-6447
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
9973
CT
Other
Enumeration date
06/01/2017
Last updated
06/01/2017
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