Healthcare Provider Details

I. General information

NPI: 1013830702
Provider Name (Legal Business Name): BRACKEN GODFREY DDS MS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 CLARK WAY STE A
SOMERSWORTH NH
03878-4403
US

IV. Provider business mailing address

8 CLARK WAY STE A
SOMERSWORTH NH
03878-4403
US

V. Phone/Fax

Practice location:
  • Phone: 603-692-2045
  • Fax: 603-692-3081
Mailing address:
  • Phone: 603-692-2045
  • Fax: 603-692-3081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: BRACKEN GODFREY
Title or Position: OWNER
Credential: DDS
Phone: 603-692-2045