| NPI | 1366151102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEG HORAN Office Manager 603-974-1150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry |
| Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-11-21 |
| Last Update Date | 2023-02-08 |