Organization Name: | DENTAL SLEEP THERAPY CENTER OF NH |
NPI Number: | 1003126616 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WARD F GRAVEL (MANAGER) |
Mailing Address: | 56 John Goffe Dr Bedford |
State: | NH US |
Postal Code: | 031106110 |
Phone Number: | 6034723255 |
Fax Number: | 6034727072 |
NPI Enumeration Date: | 10/15/2010 |
NPI Last Update Date: | 10/15/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | 1198 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NH |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |