| Organization Name: | BRENTWOOD DENTAL DESIGNS, PLLC |
| NPI Number: | 1275884132 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TAMATHA L JOHNSON (OWNER/DENTIST) |
| Mailing Address: | 1 Brickyard Sq Suite 5 Epping |
| State: | NH US |
| Postal Code: | 030424402 |
| Phone Number: | 6036793679 |
| Fax Number: | 6036793779 |
| NPI Enumeration Date: | 10/01/2012 |
| NPI Last Update Date: | 10/01/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 03591 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NH |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |