| Premier Oral Surgery And Implantology Center Llc | |
|
324 Elm St Ste 201a Monroe CT 06468-2282 | |
| (203) 690-1960 | |
| Not Available |
| Full Name | Premier Oral Surgery And Implantology Center Llc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 324 Elm St Ste 201a, Monroe, Connecticut |
| Authorized Official Name and Position | Simon Bangiyev (PRESIDENT) |
| Authorized Official Contact | 2039601960 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Oral Surgery And Implantology Center Llc 324 Elm St Ste 201a Monroe CT 06468-2282 Ph: (203) 690-1960 | Premier Oral Surgery And Implantology Center Llc 324 Elm St Ste 201a Monroe CT 06468-2282 Ph: (203) 690-1960 |
| NPI Number | 1851958029 |
|---|---|
| Provider Enumeration Date | 05/23/2019 |
| Last Update Date | 05/23/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851958029 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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