| Craig A. Stasulis Dmd, Md, Oral And Maxillofacial Surgery, Inc | |
|
435 Willard Ave Unit D Newington CT 06111-2318 | |
| (860) 796-1329 | |
| Not Available |
| Full Name | Craig A. Stasulis Dmd, Md, Oral And Maxillofacial Surgery, Inc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 435 Willard Ave Unit D, Newington, Connecticut |
| Authorized Official Name and Position | Craig Allen Stasulis (OWNER) |
| Authorized Official Contact | 8605007995 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Craig A. Stasulis Dmd, Md, Oral And Maxillofacial Surgery, Inc 435 Willard Ave Unit D Newington CT 06111-2318 Ph: (860) 796-1329 | Craig A. Stasulis Dmd, Md, Oral And Maxillofacial Surgery, Inc 435 Willard Ave Unit D Newington CT 06111-2318 Ph: (860) 796-1329 |
| NPI Number | 1881237402 |
|---|---|
| Provider Enumeration Date | 10/27/2019 |
| Last Update Date | 02/25/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881237402 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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