Healthcare Provider Details

I. General information

NPI: 1841062478
Provider Name (Legal Business Name): ELITE ENDODONTICS OF NH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2023
Last Update Date: 11/07/2023
Certification Date: 11/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

182 CENTRAL ST
HUDSON NH
03051-4651
US

IV. Provider business mailing address

182 CENTRAL ST
HUDSON NH
03051-4651
US

V. Phone/Fax

Practice location:
  • Phone: 603-882-5455
  • Fax:
Mailing address:
  • Phone: 603-882-5455
  • Fax: 603-886-7999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State

VII. Legacy identifiers

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

VIII. Authorized Official

Name: DR. TADROS TADROS
Title or Position: DOCTOR
Credential: DDS, CAGS
Phone: 603-882-5455