Healthcare Provider Details

I. General information

NPI: 1700972577
Provider Name (Legal Business Name): FRANK B. DIBBLE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 11/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 KINGSTON RD
EXETER NH
03833-4357
US

IV. Provider business mailing address

136 KINGSTON RD
EXETER NH
03833-4357
US

V. Phone/Fax

Practice location:
  • Phone: 603-770-3750
  • Fax: 603-778-3933
Mailing address:
  • Phone: 603-770-3750
  • Fax: 603-778-3933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5613
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: