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General NPI Number Information
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NPI Number | 1225004005
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Entity Type | Individual
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Provider Name | EDWARD P. DALTON MD
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Gender | Male
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Dates
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Enumeration Date | 02/23/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | ELLIOT BREAST HEALTH CENTER 275 MAMMOTH ROAD, SUITE 1
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City | MANCHESTER
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State | NH
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Zip | 03109
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Country | US
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Telephone | 603-668-3067
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Fax | 603-668-0164
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Provider Business Mailing Address
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Address Line | ELLIOT BREAST HEALTH CENTER 275 MAMMOTH ROAD, SUITE 1
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City | MANCHESTER
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State | NH
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Zip | 03109
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Country | US
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Telephone | 603-668-3067
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Fax | 603-668-0164
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 5738
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License Number State | NH
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