Healthcare Provider Details

I. General information

NPI: 1053256354
Provider Name (Legal Business Name): EVE THIVIERGE DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 WILLOW ST
BERLIN NH
03570-2084
US

IV. Provider business mailing address

133 PLEASANT ST
BERLIN NH
03570-2006
US

V. Phone/Fax

Practice location:
  • Phone: 603-752-2424
  • Fax:
Mailing address:
  • Phone: 603-752-2040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number05332
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: