| NPI | 1699789651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLEY G ROTH Owner Provider 603-898-1450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: NH 2278) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2020-08-22 |