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General NPI Number Information
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NPI Number | 1992806681
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Entity Type | Organization
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Legal Business Name | LONDONDERRY ORAL SURGERY PLLC
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 03/24/2008
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Provider Practice Location Address
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Address Line | 12 PARMENTER RD UNIT A2
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City | LONDONDERRY
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State | NH
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Zip | 03053-3280
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Country | US
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Telephone | 603-893-7601
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Fax | 603-890-1179
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Provider Business Mailing Address
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Address Line | 12 PARMENTER RD UNIT A2
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City | LONDONDERRY
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State | NH
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Zip | 03053-3280
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Country | US
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Telephone | 603-893-7601
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Fax | 603-890-1179
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Authorized Official
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Title or Position | OFFICE STAFF
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Name | MRS. DONNA L REDSHAW
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Credential |
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Telephone | 603-893-7601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 3052
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 14368
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 3265
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License Number State | NH
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Taxonomy #4
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 20461
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License Number State | MA
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Taxonomy #5
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 3422
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License Number State | NH
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Taxonomy #6
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 21107
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License Number State | MA
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