Healthcare Provider Details

I. General information

NPI: 1740114263
Provider Name (Legal Business Name): ROOT TO LEAF PEDIATRICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 WILTON RD
MILFORD NH
03055-3128
US

IV. Provider business mailing address

5 WILTON RD
MILFORD NH
03055-3128
US

V. Phone/Fax

Practice location:
  • Phone: 603-522-7910
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: HEATHER M MERRILL PROCTOR
Title or Position: APRN/OWNER
Credential: APRN
Phone: 603-522-7910