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General NPI Number Information
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NPI Number | 1194911289
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Entity Type | Individual
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Provider Name | SUREN CHELIAN DMD
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Gender | Male
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Dates
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Enumeration Date | 09/21/2007
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Last Update Date | 12/16/2007
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Provider Practice Location Address
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Address Line | 29 RIVERSIDE ST UNIT D
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City | NASHUA
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State | NH
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Zip | 03062-1396
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Country | US
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Telephone | 603-882-6100
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Fax |
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Provider Business Mailing Address
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Address Line | 29 RIVERSIDE ST UNIT D
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City | NASHUA
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State | NH
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Zip | 03062-1396
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Country | US
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Telephone | 603-882-6100
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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 | 21189
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 03625
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License Number State | NH
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