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General NPI Number Information
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NPI Number | 1265073563
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Entity Type | Organization
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Legal Business Name | NORTH END DENTAL CARE PLLC
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Dates
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Enumeration Date | 10/08/2019
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Last Update Date | 10/08/2019
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Provider Practice Location Address
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Address Line | 1361 ELM ST STE 202
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City | MANCHESTER
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State | NH
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Zip | 03101-1323
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Country | US
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Telephone | 603-668-6360
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Fax |
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Provider Business Mailing Address
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Address Line | 2172 ELM ST
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City | MANCHESTER
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State | NH
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Zip | 03104-2317
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Country | US
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Telephone | 603-759-1524
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTOPHER MORIARTY
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Credential | DMD
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Telephone | 603-759-1524
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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 |
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License Number State |
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