Healthcare Provider Details

I. General information

NPI: 1790701290
Provider Name (Legal Business Name): GRETCHEN B ADAMS RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 COURT ST SUITE 270
LEBANON NH
03766-1358
US

IV. Provider business mailing address

64 BUCKINGHAM PL
LEBANON NH
03766-2609
US

V. Phone/Fax

Practice location:
  • Phone: 603-448-1830
  • Fax: 603-448-1826
Mailing address:
  • Phone: 603-252-0530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number1724
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: