| Organization Name: | ORAL & MAXILLOFACIAL SURGEONS OF CENTRAL CT PC |
| NPI Number: | 1972798338 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STEPHEN SLATER ROZEN (DDS PRESIDENT) |
| Mailing Address: | 546 South Broad St Suite 4f Meriden |
| State: | CT US |
| Postal Code: | 06450 |
| Phone Number: | 2032356339 |
| Fax Number: | 2032356339 |
| NPI Enumeration Date: | 09/10/2007 |
| NPI Last Update Date: | 09/10/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204E00000X |
| License Number: | 3716 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Oral & Maxillofacial Surgery |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |