Healthcare Provider Details

I. General information

NPI: 1154002947
Provider Name (Legal Business Name): LENK AND KUNA ORTHODONTICS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2023
Last Update Date: 07/26/2023
Certification Date: 07/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 MATHES TER
DURHAM NH
03824-2302
US

IV. Provider business mailing address

12 MATHES TER
DURHAM NH
03824-2302
US

V. Phone/Fax

Practice location:
  • Phone: 603-868-1919
  • Fax:
Mailing address:
  • Phone: 603-868-1919
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: JASON LENK
Title or Position: OWNER/MANAGER
Credential: DMD
Phone: 603-868-1919