Healthcare Provider Details

I. General information

NPI: 1215275219
Provider Name (Legal Business Name): RUTH ALEXANDER DOANE RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2013
Last Update Date: 01/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 HOSPITAL RD
PLYMOUTH NH
03264-1126
US

IV. Provider business mailing address

16 HOSPITAL RD ATTN: ADMINISTRATION
PLYMOUTH NH
03264-1126
US

V. Phone/Fax

Practice location:
  • Phone: 603-536-1120
  • Fax:
Mailing address:
  • Phone: 603-536-1120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number02744
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: