Healthcare Provider Details

I. General information

NPI: 1508542234
Provider Name (Legal Business Name): SARAH RENY DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2023
Last Update Date: 06/27/2023
Certification Date: 06/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 LOUDON RD STE 2
CONCORD NH
03301-5321
US

IV. Provider business mailing address

9 RIDGEMONT RD
WINDHAM NH
03087-1571
US

V. Phone/Fax

Practice location:
  • Phone: 603-228-9276
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number04835
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: