| NPI | 1740300029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY JOSEPH HEDSTROM Dds Owner 603-472-3667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NH 2215) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2020-08-22 |