MEDICARE: PORTSMOUTH PEDIATRIC DENTISTRY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry	2612	NH

General Provider Information

NPI Number	:	1083768188
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PORTSMOUTH PEDIATRIC DENTISTRY

Provider Business Mailing Address
First Line	:	150 GRIFFIN RD
Second Line	:
City	:	PORTSMOUTH
State	:	NH
Zip	:	03801-7131
Country	:	US
Telephone Number	:	603-436-2204
Fax Number	:

Provider Business Practice Location Address
First Line	:	150 GRIFFIN RD
Second Line	:
City	:	PORTSMOUTH
State	:	NH
Zip	:	03801-7131
Country	:	US
Telephone Number	:	603-436-2204
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	DR. DEBRA FILOCOMA
Credential	:	D.D.S.
Telephone Number	:	603-436-2204

Provider Enumeration Date	:	01/23/2007
Last Update Date	:	08/22/2020

Similar Medicare Providers

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Practice Location Address:

150 GRIFFIN RD STE 1
PORTSMOUTH, NH
03801-7131

Practice Phone: 603-436-2204
Practice Fax:

1679549927 — GEORGE BARNARD PT
Practice Location Address:

150 GRIFFIN RD , SUITE 3
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1902862931 — DR. DEBRA FILOCOMA D.D.S.
Practice Location Address:

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1174568646 — ORTHOPEDIC AND SPORT THERAPY SERVICES, LLC
Practice Location Address:

150 GRIFFIN RD , STE 3
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1750469920 — MRS. GERI R. HUNTER DMD
Practice Location Address:

150 GRIFFIN RD STE 1
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1033273842 — DR. JON JAY WENDELL D.D.S.
Practice Location Address:

150 GRIFFIN RD STE 1
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03801-7131

Practice Phone: 603-436-2204
Practice Fax: 603-436-4158

Directions to “PORTSMOUTH PEDIATRIC DENTISTRY ” Practice Location

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