Healthcare Provider Details

I. General information

NPI: 1720099120
Provider Name (Legal Business Name): DENNIS HANNON D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 11/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

262 COTTAGE ST SUITE 301
LITTLETON NH
03561-4143
US

IV. Provider business mailing address

262 COTTAGE ST SUITE 301
LITTLETON NH
03561-4143
US

V. Phone/Fax

Practice location:
  • Phone: 603-444-0003
  • Fax: 603-444-9401
Mailing address:
  • Phone: 603-444-0003
  • Fax: 603-444-9401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number3475
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: