Healthcare Provider Details

I. General information

NPI: 1598043986
Provider Name (Legal Business Name): DAVID DANIEL ANZEL D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2011
Last Update Date: 08/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 RIVERWAY PL STE A BEDFORD COMMONS
BEDFORD NH
03110-6752
US

IV. Provider business mailing address

602 RIVERWAY PL STE A BEDFORD COMMONS
BEDFORD NH
03110-6752
US

V. Phone/Fax

Practice location:
  • Phone: 603-634-0055
  • Fax:
Mailing address:
  • Phone: 603-634-0055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License NumberNH 2573
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: