| NPI | 1659145878 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN R. WILBUR Director Of Operations 603-880-1707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics |
| 1223P0700X Dentist, Prosthodontics | |
| Enumeration Date | 2023-11-08 |
| Last Update Date | 2023-11-08 |