| NPI | 1063024487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAILEY ELIZABETH GROLEAU Manager 603-527-8057 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Enumeration Date | 2020-08-18 |
| Last Update Date | 2020-08-18 |