| NPI | 1720113640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANUEL JOSEPH SOUSA President 603-898-4722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NH 1509) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2020-08-22 |