Healthcare Provider Details

I. General information

NPI: 1558386425
Provider Name (Legal Business Name): DRS. OSOFSKY D.D.S. & SABATELLE, JR. D.M.D
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 01/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 COURT STREET SUITE 270
LEBANON NH
03766
US

IV. Provider business mailing address

1 COURT STREET SUITE 270
LEBANON NH
03766
US

V. Phone/Fax

Practice location:
  • Phone: 603-448-1830
  • Fax: 603-448-1826
Mailing address:
  • Phone: 603-448-1830
  • Fax: 603-448-1826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2556
License Number StateNH

VIII. Authorized Official

Name: DR. ROBERT C. SABATELLE JR.
Title or Position: PRESIDEN
Credential: DMD
Phone: 603-448-1830