Healthcare Provider Details

I. General information

NPI: 1184119075
Provider Name (Legal Business Name): MARY PAULINE HAND DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2018
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 LAKE ST
BRISTOL NH
03222-3572
US

IV. Provider business mailing address

214 LAKE ST
BRISTOL NH
03222-3572
US

V. Phone/Fax

Practice location:
  • Phone: 603-768-1441
  • Fax:
Mailing address:
  • Phone: 603-768-1441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN23504
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number05348
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: