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General NPI Number Information
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NPI Number | 1689705931
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Entity Type | Organization
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Legal Business Name | TRUSTEES OF DARTMOUTH COLLEGE
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 06/16/2008
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Provider Practice Location Address
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Address Line | 5 ROPE FERRY RD
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City | HANOVER
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State | NH
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Zip | 03755-1404
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Country | US
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Telephone | 603-646-9456
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Fax | 603-646-9447
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Provider Business Mailing Address
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Address Line | 7 ROPE FERRY RD # 6143
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City | HANOVER
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State | NH
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Zip | 03755-1404
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Country | US
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Telephone | 603-646-9456
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Fax | 603-646-9447
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Authorized Official
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Title or Position | ASSOC DEAN AND EXECUTIVE OFFICER
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Name | GORDON TAYLOR
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Credential |
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Telephone | 603-646-9157
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1000X
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Taxonomy Name | Student Health Clinic/Center
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License Number | 0012
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License Number State | NH
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