MEDICARE: HIGHLAND FAMILY DENTAL , PC

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	1223G0001X	General Practice Dentistry	03676	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	03676	OTHER	NH	DENTAL LICENSE

General Provider Information

NPI Number	:	1528335759
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HIGHLAND FAMILY DENTAL , PC

Provider Business Mailing Address
First Line	:	57 HIGHLAND ST
Second Line	:
City	:	NEWTON
State	:	NH
Zip	:	03858-3622
Country	:	US
Telephone Number	:	603-382-6976
Fax Number	:	603-382-6902

Provider Business Practice Location Address
First Line	:	57 HIGHLAND ST
Second Line	:
City	:	NEWTON
State	:	NH
Zip	:	03858-3622
Country	:	US
Telephone Number	:	603-382-6976
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MELISSA M DENNISON NEWMAN
Credential	:	DMD
Telephone Number	:	603-382-6976

Provider Enumeration Date	:	11/16/2011
Last Update Date	:	05/08/2013

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