Healthcare Provider Details

I. General information

NPI: 1780669648
Provider Name (Legal Business Name): GREGORY DEAN OPRITZA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 03/22/2021
Certification Date: 03/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MCGREGOR ST
MANCHESTER NH
03102-3730
US

IV. Provider business mailing address

100 MCGREGOR ST
MANCHESTER NH
03102-3730
US

V. Phone/Fax

Practice location:
  • Phone: 603-663-5310
  • Fax:
Mailing address:
  • Phone: 603-663-5310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number8193
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: