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General NPI Number Information
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NPI Number | 1376712828
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Entity Type | Organization
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Legal Business Name | MCWILLIAMS AND WONSAVAGE DENTISTRY PARTNERSHIP
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Dates
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Enumeration Date | 02/28/2008
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Last Update Date | 02/28/2008
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Provider Practice Location Address
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Address Line | 71 LYME RD
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City | HANOVER
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State | NH
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Zip | 03755-1253
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Country | US
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Telephone | 603-643-3104
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Fax | 603-643-0241
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Provider Business Mailing Address
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Address Line | 71 LYME RD
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City | HANOVER
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State | NH
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Zip | 03755-1253
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Country | US
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Telephone | 603-643-3104
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Fax | 603-643-0241
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Authorized Official
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Title or Position | PARTNER
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Name | DR. ROGER W MCWILLIAMS
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Credential | D.M.D., PH.D.
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Telephone | 603-643-3104
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 1677
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License Number State | NH
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