| NPI | 1043636616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY W BRADIGAN Owner 603-643-1700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: NH 2601) |
| Additional Taxonomies | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: NH 03746) |
| Enumeration Date | 2014-03-06 |
| Last Update Date | 2014-03-06 |