| Gm Surgical Associates Llc | |
|
130 New London Tpke Ste 3 Norwich CT 06360-2624 | |
| (860) 886-0651 | |
| Not Available |
| Full Name | Gm Surgical Associates Llc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 130 New London Tpke Ste 3, Norwich, Connecticut |
| Authorized Official Name and Position | Bryan Thomas Meriam (MEMBER) |
| Authorized Official Contact | 9172820647 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gm Surgical Associates Llc 23 Meadowbrook Rd Madison CT 06443-2557 Ph: (203) 787-6581 | Gm Surgical Associates Llc 130 New London Tpke Ste 3 Norwich CT 06360-2624 Ph: (860) 886-0651 |
| NPI Number | 1912428160 |
|---|---|
| Provider Enumeration Date | 06/28/2017 |
| Last Update Date | 06/28/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912428160 | NPI | - | NPPES |
| 1285869107 | Medicaid | CT | |
| 1629218961 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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