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General NPI Number Information
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NPI Number | 1689764334
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Entity Type | Organization
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Legal Business Name | ORAL AND MAXILLOFACIAL SURGEONS PC
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 80 SOUTH MAIN STREET
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City | MIDDLETOWN
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State | CT
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Zip | 06457
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Country | US
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Telephone | 860-347-6939
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Fax | 860-347-7993
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Provider Business Mailing Address
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Address Line | 80 SOUTH MAIN STREET
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City | MIDDLETOWN
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State | CT
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Zip | 06457
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Country | US
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Telephone | 860-347-6939
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Fax | 860-347-7993
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ARTHUR L SPERLING
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Credential | DMD
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Telephone | 860-347-6939
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number |
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License Number State |
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