Healthcare Provider Details

I. General information

NPI: 1154525624
Provider Name (Legal Business Name): NHOMS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2007
Last Update Date: 07/21/2022
Certification Date: 07/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 TRAFALGAR SQ SUITE 201
NASHUA NH
03063-4900
US

IV. Provider business mailing address

33 TRAFALGAR SQ SUITE 201
NASHUA NH
03063-4900
US

V. Phone/Fax

Practice location:
  • Phone: 603-595-8889
  • Fax: 603-595-2027
Mailing address:
  • Phone: 603-595-8889
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS0112X
TaxonomyOral and Maxillofacial Surgery Clinic/Center
License Number3216
License Number StateNH

VIII. Authorized Official

Name: DR. NADER MOAVENIAN
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 603-595-8889