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EAST LYME ORAL AND MAXILLOFACIAL SURGERY NPI 1205906369


NPI Information

NPI: 1205906369
Provider Name: EAST LYME ORAL AND MAXILLOFACIAL SURGERY
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
314 FLANDERS RD
SUITE 1B
EAST LYME, CT
ZIP 06333
Phone: (860) 739-3133
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EAST LYME ORAL AND MAXILLOFACIAL SURGERY is an oral and maxillofacial surgery dentist in East Lyme, CT. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. EAST LYME ORAL AND MAXILLOFACIAL SURGERY NPI is 1205906369. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

314 FLANDERS RD
SUITE 1B
EAST LYME, CT
ZIP 06333-727
Phone: (860) 739-3133
Fax: (860) 739-3131

The provider's authorized official is Kirk Fred Engel .
The authorized official title is Member And Owner and has the following contact phone number (860) 739-3133.

The enumeration date for this NPI number is 11/8/2006 and was last updated on 8/25/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223S0112XDentistOral and Maxillofacial Surgery007384CONNECTICUTYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11659376507OTHERCONNECTICUTNPI FOR DR. KIRK ENGEL

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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