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General Practice Dentist

Lebanon, New Hampshire

Provider NPI: 1538234380

Provider Information:
Gender: M
Not Sole Proprietor

Practice Location:
Tel: 603-643-4362  Fax: 603-643-4340

Business Mailing Address:
PO BOX 682 367 ROUTE 120 BLDG D HANOVER, NH 03755 US
Tel: 603-643-4362  Fax: 603-643-4340

Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y1223G0001XDental Providers
General Practice


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