Healthcare Provider Details

I. General information

NPI: 1689614059
Provider Name (Legal Business Name): SYLVIA S CHRISTIAN DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 10/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1558 HOOKSETT RD
HOOKSETT NH
03106-1600
US

IV. Provider business mailing address

1558 HOOKSETT RD STE 4
HOOKSETT NH
03106-1600
US

V. Phone/Fax

Practice location:
  • Phone: 603-485-4855
  • Fax: 603-485-2500
Mailing address:
  • Phone: 603-232-6512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number3219
License Number StateNH

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: