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General NPI Number Information
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NPI Number | 1235522558
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Entity Type | Organization
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Legal Business Name | PLAISTOW PEDIATRIC DENTISTRY & ORTHODONTICS
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Dates
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Enumeration Date | 03/11/2015
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Last Update Date | 01/14/2016
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Provider Practice Location Address
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Address Line | 166 PLAISTOW RD
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City | PLAISTOW
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State | NH
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Zip | 03865-2843
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Country | US
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Telephone | 603-499-4535
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Fax |
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Provider Business Mailing Address
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Address Line | 166 PLAISTOW RD
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City | PLAISTOW
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State | NH
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Zip | 03865-2843
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Country | US
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Telephone | 603-974-1150
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. JON J WENDELL
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Credential |
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Telephone | 603-974-1150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 2493
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License Number State | NH
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