Healthcare Provider Details

I. General information

NPI: 1932294600
Provider Name (Legal Business Name): JAMES R METCALF DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 TRAFALGAR SQUARE
NASHUA NH
03063
US

IV. Provider business mailing address

1 TRAFALGAR SQUARE
NASHUA NH
03063
US

V. Phone/Fax

Practice location:
  • Phone: 603-882-2101
  • Fax: 603-882-3803
Mailing address:
  • Phone: 603-882-2101
  • Fax: 603-882-3803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number1835
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: