| Fairfield Oms Llc | |
|
760 Kings Hwy W Bldg B Southport CT 06890-3102 | |
| (203) 259-2227 | |
| Not Available |
| Full Name | Fairfield Oms Llc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 760 Kings Hwy W Bldg B, Southport, Connecticut |
| Authorized Official Name and Position | Chad Hendricks (CREDENTIALING) |
| Authorized Official Contact | 6128590444 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairfield Oms Llc 760 Kings Hwy W Bldg B Southport CT 06890-3102 Ph: (203) 259-2227 | Fairfield Oms Llc 760 Kings Hwy W Bldg B Southport CT 06890-3102 Ph: (203) 259-2227 |
| NPI Number | 1437031101 |
|---|---|
| Provider Enumeration Date | 07/23/2025 |
| Last Update Date | 07/23/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437031101 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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