Healthcare Provider Details

I. General information

NPI: 1124690961
Provider Name (Legal Business Name): AMAZING FAMILY DENTAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2021
Last Update Date: 07/12/2021
Certification Date: 07/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 W RIVER RD UNIT 2
HOOKSETT NH
03106-2635
US

IV. Provider business mailing address

311 W RIVER RD UNIT 2
HOOKSETT NH
03106-2635
US

V. Phone/Fax

Practice location:
  • Phone: 603-485-7600
  • Fax: 603-485-8961
Mailing address:
  • Phone: 603-485-7600
  • Fax: 603-485-8961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MANAL ELFAHAL
Title or Position: OWNER/DENTIST
Credential: DMD
Phone: 603-485-7600