Healthcare Provider Details
I. General information
NPI: 1396024105
Provider Name (Legal Business Name): THOMAS PAUL SURANYI DDS MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/10/2011
Last Update Date: 06/12/2023
Certification Date: 06/12/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4 EPPING RD
EXETER NH
03833-1519
US
IV. Provider business mailing address
62 MAGNOLIA DR
PELHAM NH
03076-5106
US
V. Phone/Fax
- Phone: 603-836-8580
- Fax:
- Phone: 34-014-8806
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223P0700X |
| Taxonomy | Prosthodontics |
| License Number | 04165 |
| License Number State | NH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: