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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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