UCONN HEALTH CENTER
Oral and Maxillofacial Radiology
Farmington, Connecticut
Provider NPI: 1770572588
Organization Information:Organization Name: UCONN HEALTH CENTER
Organization is not Subpart
Authorized Official: ALAN G. LURIE PROFESSOR 860-6792453
Practice Location:
263 FARMINGTON AVE ORAL AND MAXILLOFACIAL RADIOLOGY MC 2110 FARMINGTON, CT 06030 US
Tel: 860-679-2453 Fax: 860-679-2756
Business Mailing Address:
263 FARMINGTON AVE ORAL AND MAXILLOFACIAL RADIOLOGY MC 2110 FARMINGTON, CT 06030 US
Tel: 860-679-2453 Fax: 860-679-2756
Entity Type: Organization
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 1223X0008X | Dental Providers Dentist Oral and Maxillofacial Radiology | CT | 004751 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
2047513 | CT | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
JOBS CT
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