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General NPI Number Information
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NPI Number | 1104049204
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Entity Type | Individual
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Provider Name | DR. HENRY ROBERT DAVID
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Gender | Male
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 09/03/2008
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Provider Practice Location Address
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Address Line | 14 LOUDON RD
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City | CONCORD
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State | NH
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Zip | 03301-5344
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Country | US
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Telephone | 603-227-9899
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 792
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City | CENTER HARBOR
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State | NH
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Zip | 03226-0792
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Country | US
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Telephone |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 1453
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License Number State | NH
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