| Premier Oral Surgery And Implantology Center Llc | |
|
411 Barnum Avenue Cutoff Ste 5 Stratford CT 06614-5100 | |
| (203) 960-1960 | |
| Not Available |
| Full Name | Premier Oral Surgery And Implantology Center Llc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 411 Barnum Avenue Cutoff Ste 5, Stratford, Connecticut |
| Authorized Official Name and Position | Simon Y Bangiyev (PRESIDENT) |
| Authorized Official Contact | 2036901960 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Oral Surgery And Implantology Center Llc 411 Barnum Avenue Cutoff Ste 5 Stratford CT 06614-5100 Ph: (203) 960-1960 | Premier Oral Surgery And Implantology Center Llc 411 Barnum Avenue Cutoff Ste 5 Stratford CT 06614-5100 Ph: (203) 960-1960 |
| NPI Number | 1952898025 |
|---|---|
| Provider Enumeration Date | 04/15/2018 |
| Last Update Date | 04/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952898025 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 11114 (Connecticut) | Primary |
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