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General NPI Number Information
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NPI Number | 1780964189
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Entity Type | Organization
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Legal Business Name | D&K DENTAL LLC
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Dates
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Enumeration Date | 08/17/2011
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Last Update Date | 03/26/2024
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Provider Practice Location Address
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Address Line | 57 NORTHEASTERN BLVD STE 201
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City | NASHUA
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State | NH
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Zip | 03062-3154
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Country | US
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Telephone | 603-521-8411
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Fax | 603-518-5170
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Provider Business Mailing Address
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Address Line | 155 MAIN DUNSTABLE RD STE. 140
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City | NASHUA
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State | NH
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Zip | 03060-3640
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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 | DENTIST
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Name | DR. KELLY B WHELAN
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Credential | DMD
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Telephone | 978-877-9782
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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 | 03851
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License Number State | NH
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