Healthcare Provider Details

I. General information

NPI: 1386715068
Provider Name (Legal Business Name): PAUL J. KRAUTMANN D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: PAUL J. KRAUTMANN D.D.S.

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

248 PLEASANT ST SUITE 1800
CONCORD NH
03301-2588
US

IV. Provider business mailing address

258 COURT ST
KEENE NH
03431-3450
US

V. Phone/Fax

Practice location:
  • Phone: 603-224-3339
  • Fax: 603-224-3330
Mailing address:
  • Phone: 603-352-6481
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number1605
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: