Healthcare Provider Details

I. General information

NPI: 1831304294
Provider Name (Legal Business Name): LAURIE A. ROSATO, DMD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 LOUDON RD SUITE 2
CONCORD NH
03301-5321
US

IV. Provider business mailing address

6 LOUDON RD SUITE 2
CONCORD NH
03301-5321
US

V. Phone/Fax

Practice location:
  • Phone: 603-228-9276
  • Fax: 603-228-7305
Mailing address:
  • Phone: 603-228-9276
  • Fax: 603-228-7305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number3211
License Number StateNH

VIII. Authorized Official

Name: DR. LAURIE A ROSATO
Title or Position: DENTIST
Credential: DMD
Phone: 603-228-9276