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General NPI Number Information
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NPI Number | 1972547958
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Entity Type | Individual
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Provider Name | CAROLYN COWEN CHASE DMD
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Gender | Female
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Dates
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Enumeration Date | 06/16/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1000 ISLINGTON ST
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City | PORTSMOUTH
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State | NH
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Zip | 03801-4224
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Country | US
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Telephone | 603-436-8030
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Fax | 603-436-0019
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Provider Business Mailing Address
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Address Line | 8 FIRE ROAD 268
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City | STRAFFORD
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State | NH
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Zip | 03884-6722
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Country | US
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Telephone | 603-664-1503
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Fax | 603-436-0019
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 2021
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License Number State | NH
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