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General NPI Number Information
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NPI Number | 1902837206
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Entity Type | Individual
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Provider Name | CHRISTOPHER JAMES ROOT DMD
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Gender | Male
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 31 OLD ETNA RD SUITES N1 AND N2
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City | LEBANON
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State | NH
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Zip | 03766-1933
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Country | US
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Telephone | 603-448-3800
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Fax | 603-448-0553
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Provider Business Mailing Address
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Address Line | 82 RIVERVALE RD
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City | PIERMONT
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State | NH
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Zip | 03779-3106
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3487
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License Number State | NH
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