Healthcare Provider Details

I. General information

NPI: 1225486814
Provider Name (Legal Business Name): EMAN ISABELLE CARREON DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: EMAN OUABIRA DMD

II. Dates (important events)

Enumeration Date: 05/25/2016
Last Update Date: 08/04/2021
Certification Date: 08/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 NH 27
RAYMOND NH
03077-1273
US

IV. Provider business mailing address

29 BRIALLIA CIR
NEWMARKET NH
03857-2194
US

V. Phone/Fax

Practice location:
  • Phone: 603-895-5600
  • Fax:
Mailing address:
  • Phone: 617-708-5720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN1857222
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number04270
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: