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General NPI Number Information
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NPI Number | 1326358680
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Entity Type | Organization
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Legal Business Name | COLLINS DENTISTRY FOR CHILDREN
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Dates
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Enumeration Date | 10/20/2010
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Last Update Date | 10/20/2010
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Provider Practice Location Address
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Address Line | 76 ALLDS ST STE 5
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City | NASHUA
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State | NH
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Zip | 03060-4704
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Country | US
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Telephone | 603-718-8587
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Fax | 603-718-8592
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Provider Business Mailing Address
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Address Line | 76 ALLDS ST STE 5
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City | NASHUA
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State | NH
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Zip | 03060-4704
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Country | US
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Telephone | 603-718-8587
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Fax | 603-718-8592
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | MS. VICTORIA M NOLET
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Credential |
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Telephone | 603-635-1166
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 3214
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License Number State | NH
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