Columbia Oral Maxillofacial Imaging LLC

NPI #1134240922 in Manchester, Connecticut

Provider Information

NPI Number: 1134240922
Entity Type: Organization
Organization Name: Columbia Oral Maxillofacial Imaging LLC
Primary Specialty: Dentist
Enumeration Date: Apr 2, 2007
Last Updated: Sep 20, 2012

Practice Location

Address: 483 MIDDLE TPKE W
City: Manchester
State: Connecticut
ZIP Code: 06040-3863
Phone: (860) 645-0111

Authorized Official

Name: BIBI KHAN
Title: PRACTICE MANAGER
Phone: (860) 645-0111

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Periodontics — Periodontics	1223P0300X
Dentist	122300000X	Primary

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