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General NPI Number Information
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NPI Number | 1659701563
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Entity Type | Individual
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Provider Name | CAROLYN FERRICK DECOTEAU DMD
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Gender | Female
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Dates
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Enumeration Date | 11/14/2013
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Last Update Date | 09/05/2023
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Provider Practice Location Address
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Address Line | 169 KINSLEY ST
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City | NASHUA
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State | NH
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Zip | 03060-3636
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Country | US
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Telephone | 603-589-9222
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Fax |
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Provider Business Mailing Address
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Address Line | 51 GREAT BROOK PATH
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City | CARLISLE
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State | MA
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Zip | 01741-1256
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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 |
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Name |
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Credential |
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Telephone |
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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 | DN1856520
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License Number State | MA
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