Premier Oral Surgery and Implantology Center LLC
NPI #1518794338 in Cos Cob, Connecticut
Provider Information
- NPI Number
- 1518794338
- Entity Type
- Organization
- Organization Name
- Premier Oral Surgery and Implantology Center LLC
- Primary Specialty
- Dentist - Oral and Maxillofacial Surgery
- Enumeration Date
- Sep 16, 2024
- Last Updated
- Sep 16, 2024
Practice Location
- Address
- 211 E PUTNAM AVE STE 2-6
- City
- Cos Cob
- State
- Connecticut
- ZIP Code
- 06807-2734
- Phone
- (203) 303-9693
Authorized Official
- Name
- DR. SIMON BANGIYEV, DDS, MD
- Title
- OWNER
- Phone
- (203) 303-9693
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery |
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