| NPI | 1568996585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE A GAILLARDETZ Owner 603-321-9029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: SC 8715) |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2017-04-17 |