| NPI | 1992928410 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE ENNIS Office Manager 603-889-2164 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: NH 3217) |
| Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: NH 3222) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2020-08-22 |