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General NPI Number Information
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NPI Number | 1487450433
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Entity Type | Organization
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Legal Business Name | DENTAL GROUP ASSOCIATES OF NEW HAMPSHIRE PC
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Dates
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Enumeration Date | 02/20/2025
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Last Update Date | 02/20/2025
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Provider Practice Location Address
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Address Line | 10 COMMERCIAL ST
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City | CONCORD
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State | NH
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Zip | 03301-5031
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Country | US
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Telephone | 941-504-6424
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Fax |
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Provider Business Mailing Address
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Address Line | 8429 LORRAINE RD STE 426
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City | LAKEWOOD RANCH
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State | FL
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Zip | 34202-9010
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MARK SIVERS
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Credential | DMD
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Telephone | 941-893-2406
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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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