Healthcare Provider Details

I. General information

NPI: 1518170141
Provider Name (Legal Business Name): SCOTT F BOBBITT DMD P A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 12/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

76 ALLDS ST STE 6
NASHUA NH
03060-4704
US

IV. Provider business mailing address

76 ALLDS ST STE 6
NASHUA NH
03060-4758
US

V. Phone/Fax

Practice location:
  • Phone: 603-882-3001
  • Fax: 603-882-3683
Mailing address:
  • Phone: 603-882-3001
  • Fax: 603-882-3683

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2562
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number2562
License Number StateNH

VIII. Authorized Official

Name: HEATHER BOBBITT
Title or Position: BUS MGRCFOCLERK OF CORP
Credential:
Phone: 603-882-3001