Healthcare Provider Details

I. General information

NPI: 1184170755
Provider Name (Legal Business Name): LOWELL ORAL SURGERY ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2016
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 COTTON RD SUITE 202
NASHUA NH
03063-1262
US

IV. Provider business mailing address

20 COTTON RD SUITE 202
NASHUA NH
03063-1262
US

V. Phone/Fax

Practice location:
  • Phone: 603-595-9119
  • Fax: 603-595-8753
Mailing address:
  • Phone: 603-595-9119
  • Fax: 603-595-8753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. PATRICIA LYNN YOUNG
Title or Position: CEO
Credential: MBA, FACMPE
Phone: 978-458-1264