| NPI | 1598716755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD SHANSHALA Chief Executive Officer 603-444-8223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 1223G0001X Dentist General Practice |
| Enumeration Date | 2006-05-13 |
| Last Update Date | 2019-04-16 |