Healthcare Provider Details

I. General information

NPI: 1003391590
Provider Name (Legal Business Name): ANNETTE LISA COLE RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2018
Last Update Date: 10/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

262 COTTAGE ST STE 230
LITTLETON NH
03561-4143
US

IV. Provider business mailing address

262 COTTAGE ST STE 230
LITTLETON NH
03561-4143
US

V. Phone/Fax

Practice location:
  • Phone: 603-259-3700
  • Fax: 603-444-0945
Mailing address:
  • Phone: 603-259-3700
  • Fax: 603-444-0945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number01839
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: