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PEDIATRIC DENTISTRY OF SALEM

Pediatric Dentistry

Salem, New Hampshire

Provider NPI: 1992825137

Organization Information:
Organization Name:  PEDIATRIC DENTISTRY OF SALEM
Authorized Official:  ADAM  WOLFF  MANAGER  603-8935266

Practice Location:
389 MAIN ST  SALEM, NH 03079 US
Tel: 603-893-5266  Fax: 603-898-3475

Business Mailing Address:
389 MAIN ST  SALEM, NH 03079 US
Tel: 603-893-5266  Fax: 603-898-3475

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N1223P0221XDental Providers
Dentist
Pediatric Dentistry
NH2359
Y1223P0221XDental Providers
Dentist
NH3275

Other Provider Identifiers:

IssuerNumberStateType
30313204NH05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin



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