Healthcare Provider Details

I. General information

NPI: 1043864911
Provider Name (Legal Business Name): STRATHAM FAMILY DENTAL ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2019
Last Update Date: 07/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 RAEDER DR
STRATHAM NH
03885-2313
US

IV. Provider business mailing address

2 RAEDER DR
STRATHAM NH
03885-2313
US

V. Phone/Fax

Practice location:
  • Phone: 603-772-6260
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. BRYAN DAWLEY
Title or Position: OWNER
Credential: DMD
Phone: 603-772-6260