| Ridgefield Oral And Maxillofacial Surgery, Llc | |
|
10 South St Ste 202 Ridgefield CT 06877-4125 | |
| (203) 403-3686 | |
| Not Available |
| Full Name | Ridgefield Oral And Maxillofacial Surgery, Llc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 10 South St Ste 202, Ridgefield, Connecticut |
| Authorized Official Name and Position | Steven Edward Smullin (OWNER) |
| Authorized Official Contact | 2034033686 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ridgefield Oral And Maxillofacial Surgery, Llc 87 Brookhollow Ln Stamford CT 06902-1014 Ph: (617) 230-1152 | Ridgefield Oral And Maxillofacial Surgery, Llc 10 South St Ste 202 Ridgefield CT 06877-4125 Ph: (203) 403-3686 |
| NPI Number | 1083173538 |
|---|---|
| Provider Enumeration Date | 03/14/2019 |
| Last Update Date | 03/14/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083173538 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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