| NPI | 1407133234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUNA L GAUTHIER Owner 603-527-1700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: NH 03806) |
| Enumeration Date | 2011-11-08 |
| Last Update Date | 2011-11-08 |