Healthcare Provider Details

I. General information

NPI: 1922294685
Provider Name (Legal Business Name): O.M.S. ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2007
Last Update Date: 01/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 TORRINGTON PLAZA SUITE 103
TORRINGTON CT
06790
US

IV. Provider business mailing address

1 TORRINGTON PLAZA SUITE 103
TORRINGTON CT
06790
US

V. Phone/Fax

Practice location:
  • Phone: 860-482-5779
  • Fax: 860-496-2345
Mailing address:
  • Phone: 860-482-5779
  • Fax: 860-496-2345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License Number7490
License Number StateCT

VIII. Authorized Official

Name: DR. THOMAS C MCKEON
Title or Position: PRESIDENT
Credential: DMD
Phone: 860-482-5779