| NPI | 1417055047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIANA LARSEN Financial Adminstrator 603-924-3040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-08-22 |