| Columbia Oral Maxillofacial Imaging Llc | |
|
483 Middle Tpke W Manchester CT 06040-3863 | |
| (860) 645-0111 | |
| Not Available |
| Full Name | Columbia Oral Maxillofacial Imaging Llc |
|---|---|
| Speciality | Dentist |
| Location | 483 Middle Tpke W, Manchester, Connecticut |
| Authorized Official Name and Position | Bibi Khan (PRACTICE MANAGER) |
| Authorized Official Contact | 8606450111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Columbia Oral Maxillofacial Imaging Llc 483 Middle Tpke W Manchester CT 06040-3863 Ph: (860) 645-0111 | Columbia Oral Maxillofacial Imaging Llc 483 Middle Tpke W Manchester CT 06040-3863 Ph: (860) 645-0111 |
| NPI Number | 1134240922 |
|---|---|
| Provider Enumeration Date | 04/02/2007 |
| Last Update Date | 09/20/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134240922 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Secondary |
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