Healthcare Provider Details

I. General information

NPI: 1770348591
Provider Name (Legal Business Name): NHOMS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2024
Last Update Date: 02/20/2024
Certification Date: 02/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 S BEDFORD ST STE 202
BURLINGTON MA
01803-5145
US

IV. Provider business mailing address

33 TRAFALGAR SQ STE 201
NASHUA NH
03063-4901
US

V. Phone/Fax

Practice location:
  • Phone: 781-425-1030
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: JO A GOY
Title or Position: CREDENTIALING
Credential:
Phone: 603-595-8889