| NPI | 1942705124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY M DECOTEAU President 603-589-9222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2018-03-28 |