| Greater Waterbury Oral & Maxillofacial Surgeons Llc | |
|
1389 W Main St Suite 320 Waterbury CT 06708-3104 | |
| (203) 573-1427 | |
| (203) 574-2460 |
| Full Name | Greater Waterbury Oral & Maxillofacial Surgeons Llc |
|---|---|
| Speciality | Dentist |
| Location | 1389 W Main St, Waterbury, Connecticut |
| Authorized Official Name and Position | John J Hillgen (OWNER) |
| Authorized Official Contact | 2035731427 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Greater Waterbury Oral & Maxillofacial Surgeons Llc 1389 W Main St Suite 320 Waterbury CT 06708-3104 Ph: (203) 573-1427 | Greater Waterbury Oral & Maxillofacial Surgeons Llc 1389 W Main St Suite 320 Waterbury CT 06708-3104 Ph: (203) 573-1427 |
| NPI Number | 1033136825 |
|---|---|
| Provider Enumeration Date | 07/16/2006 |
| Last Update Date | 04/09/2015 |
| Medicare PECOS PAC ID | 8921194168 |
|---|---|
| Medicare Enrollment ID | O20071107000063 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033136825 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | John Hillgen |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1538193370 PECOS PAC ID: 1557457702 Enrollment ID: I20071018000661 |
| Provider Name | Elie M Ferneini |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1992997050 PECOS PAC ID: 6901979764 Enrollment ID: I20080728000064 |
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