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General NPI Number Information
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NPI Number | 1134337751
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Entity Type | Organization
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Legal Business Name | ROBERT A FREMEAU DMD
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 09/04/2007
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Provider Practice Location Address
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Address Line | 30 CANTON ST SUITE 12
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City | MANCHESTER
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State | NH
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Zip | 03103-3524
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Country | US
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Telephone | 603-668-6434
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Fax |
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Provider Business Mailing Address
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Address Line | 10 SUNRISE BLVD
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City | HOOKSETT
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State | NH
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Zip | 03106-2606
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Country | US
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Telephone | 603-668-6356
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | ALISON SMITH
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Credential |
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Telephone | 603-668-6434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 1444
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License Number State | NH
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