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General NPI Number Information
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NPI Number | 1093507022
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Entity Type | Individual
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Provider Name | KENNETH LI DMD
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Gender | Male
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Dates
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Enumeration Date | 05/17/2025
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Last Update Date | 09/05/2025
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Provider Practice Location Address
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Address Line | 72 S RIVER RD
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City | BEDFORD
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State | NH
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Zip | 03110-6759
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Country | US
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Telephone | 603-624-3900
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Fax |
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Provider Business Mailing Address
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Address Line | 250 COMMERCIAL ST APT 411
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City | MANCHESTER
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State | NH
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Zip | 03101-1125
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Country | US
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Telephone | 781-801-8814
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 05217
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License Number State | NH
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