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General NPI Number Information
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NPI Number | 1326251935
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Entity Type | Organization
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Legal Business Name | WILLLIAM A. MEHAN, DMD PROFESSIONAL ASSOC.
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 113 MAMMOTH RD
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City | MANCHESTER
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State | NH
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Zip | 03109-4337
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Country | US
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Telephone | 603-623-8003
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Fax | 603-623-1191
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Provider Business Mailing Address
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Address Line | 113 MAMMOTH RD
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City | MANCHESTER
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State | NH
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Zip | 03109-4337
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Country | US
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Telephone | 603-623-8003
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Fax | 603-623-1191
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM A. MEHAN
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Credential | DMD
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Telephone | 603-623-8003
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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 | 1423
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License Number State | NH
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