| NPI | 1144355603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD W RANDAZZO Owner 603-635-2151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NH 1270) |
| Additional Taxonomies | 122300000X Dentist (Licence: NH 3390) |
| 1223P0300X Dentist Periodontics (Licence: NH 3420) | |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: NH 2779) | |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2020-08-22 |