Ridgefield Oral And Maxillofacial Surgery, LLC
Dentist, Oral and Maxillofacial Surgery in Ridgefield, CT. Organization (NPI-2).
NPI number1083173538
StatusActive
Last updated in NPPESMar 14, 2019
Details
- NPI
- 1083173538
- Entity type
- Organization (NPI-2)
- Legal business name
- Ridgefield Oral And Maxillofacial Surgery, LLC
- Organization subpart
- No
- Enumeration date
- Mar 14, 2019
- Last updated
- Mar 14, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223S0112X | Dentist, Oral and Maxillofacial Surgery | – | – | Yes |
Practice location
10 South St Ste 202Ridgefield, CT 06877-4125
Phone 203-403-3686
Mailing address
87 Brookhollow LnStamford, CT 06902-1014
Phone 617-230-1152
Authorized official
Steven Edward Smullin
Owner
2034033686
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