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NPI Code Detail

MEDICARE: DR. STEPHEN ENRICO FUCINI DMD

MEDICARE:  DR. STEPHEN ENRICO FUCINI  DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223P0300XPeriodontics2563NH

General Provider Information

NPI Number : 1649254665
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEPHEN ENRICO FUCINI DMD
Provider Business Mailing Address
First Line : 73 LYME RD
Second Line : STE #2
City : HANOVER
State : NH
Zip : 03755
Country : US
Telephone Number : 603-643-0501
Fax Number : 603-643-4676
Provider Business Practice Location Address
First Line : 73 LYME RD
Second Line : STE #2
City : HANOVER
State : NH
Zip : 03755
Country : US
Telephone Number : 603-643-0501
Fax Number : 603-643-4676
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2005
Last Update Date : 07/08/2007

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Directions to “ DR. STEPHEN ENRICO FUCINI DMD” Practice Location

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