Healthcare Provider Details

I. General information

NPI: 1841403706
Provider Name (Legal Business Name): NATHAN A SWANSON DDS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 MAIN ST
NEWMARKET NH
03857-1607
US

IV. Provider business mailing address

80 MAIN ST
NEWMARKET NH
03857-1607
US

V. Phone/Fax

Practice location:
  • Phone: 603-659-3392
  • Fax:
Mailing address:
  • Phone: 603-659-3392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number3327
License Number StateNH

VIII. Authorized Official

Name: DR. NATHAN A SWANSON
Title or Position: OWNER
Credential: DDS
Phone: 603-659-3392