| Organization Name: | GRANITE FAMILY DENTISTRTY |
| NPI Number: | 1376686790 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SYLVIA CHRISTIAN (OWNER) |
| Mailing Address: | 1558 Hooksett Rd Hooksett |
| State: | NH US |
| Postal Code: | 031061600 |
| Phone Number: | 6034854855 |
| Fax Number: | 6034852500 |
| NPI Enumeration Date: | 02/15/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 3219 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NH |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |