Healthcare Provider Details
I. General information
NPI: 1053678789
Provider Name (Legal Business Name): SAVING PEOPLE'S SMILE DENTAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/19/2012
Last Update Date: 04/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
194 PLEASANT ST SUITE 6
CONCORD NH
03301-2952
US
IV. Provider business mailing address
194 PLEASANT ST SUITE 6
CONCORD NH
03301-2952
US
V. Phone/Fax
- Phone: 603-219-0770
- Fax: 603-219-0337
- Phone: 603-219-0770
- Fax: 603-219-0337
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QD0000X |
| Taxonomy | Dental Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
EARLE
WYATT
SIMPSON
JR.
Title or Position: DENTIST
Credential: D.M.D.
Phone: 603-219-0770