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General NPI Number Information
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NPI Number | 1760736599
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Entity Type | Organization
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Legal Business Name | PLYMOUTH GENERAL DENTISTRY, PLLC
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Dates
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Enumeration Date | 10/31/2012
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Last Update Date | 01/21/2020
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Provider Practice Location Address
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Address Line | 65 HIGHLAND ST
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City | PLYMOUTH
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State | NH
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Zip | 03264-1232
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Country | US
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Telephone | 603-536-4301
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Fax | 603-536-1984
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Provider Business Mailing Address
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Address Line | 65 HIGHLAND ST
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City | PLYMOUTH
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State | NH
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Zip | 03264-1232
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Country | US
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Telephone | 603-536-4301
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Fax | 603-536-1984
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Authorized Official
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Title or Position | OWNER
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Name | JOAN KIRSCHNER
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Credential | D.D.S.
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Telephone | 603-536-4301
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 03952
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License Number State | NH
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