=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891597266
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARGAUX HEID BLACKSTONE RDH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/26/2025
-----------------------------------------------------
Last Update Date | 03/26/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 51 WEBB PL STE 200
-----------------------------------------------------
City | DOVER
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03820-2454
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-742-3321
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4 PINE ST
-----------------------------------------------------
City | NEWMARKET
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03857-1504
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-352-1958
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 124Q00000X
-----------------------------------------------------
Taxonomy Name | Dental Hygienist
-----------------------------------------------------
License Number | 03810
-----------------------------------------------------
License Number State | NH
-----------------------------------------------------