Organization
ORAL & MAXILLOFACIAL SURGEONS OF MILFORD & DERBY, PC
Active
Organization
ORAL & MAXILLOFACIAL SURGEONS OF MILFORD & DERBY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRISTA D FABIAN (PRACTICE MANAGER)
(203) 874-1664
Entity
Organization
Contact information
Practice address
1 GOLDEN HILL ST, MILFORD, CT 06460-4630
(203) 874-1664
(203) 877-2027
Mailing address
1 GOLDEN HILL ST, MILFORD, CT 06460-4630
(203) 874-1664
(203) 877-2027
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020004683CT02
ANTHEM BLUE CROSS
CT
01
—
020006602CT01
ANTHEM BLUE CROSS
CT
Enumeration date
03/01/2007
Last updated
04/18/2013
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