Organization
CRAIG A. STASULIS DMD, MD, ORAL AND MAXILLOFACIAL SURGERY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRAIG ALLEN STASULIS DMD, MD (OWNER)
(860) 500-7995
Entity
Organization
Contact information
Practice address
435 WILLARD AVE UNIT D, NEWINGTON, CT 06111-2318
(860) 796-1329
Mailing address
435 WILLARD AVE UNIT D, NEWINGTON, CT 06111-2318
(860) 796-1329
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
10/27/2019
Last updated
02/25/2020
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