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General NPI Number Information
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NPI Number | 1922506914
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Entity Type | Organization
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Legal Business Name | MERRIMACK VALLEY DENTAL CARE
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Dates
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Enumeration Date | 01/25/2018
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Last Update Date | 01/25/2018
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Provider Practice Location Address
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Address Line | 155 MAIN DUNSTABLE RD STE 220
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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 | 603-883-0833
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Fax |
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Provider Business Mailing Address
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Address Line | 155 MAIN DUNSTABLE RD STE 220
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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 | 603-883-0833
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | ALBERT ST. GERMAIN
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Credential | DSS
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Telephone | 603-883-0833
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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