Organization
COUNTY OF GRAFTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN L JURENTKUFF (CFO)
(603) 787-6971
Entity
Organization
Contact information
Practice address
3855 DARTMOUTH COLLEGE HWY, NORTH HAVERHILL, NH 03774-4909
(603) 787-6971
(603) 787-2035
Mailing address
3855 DARTMOUTH COLLEGE HWY, NORTH HAVERHILL, NH 03774-4909
(603) 787-6971
(603) 787-2035
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
1053319517
NH
314000000X
Skilled Nursing Facility
Primary
00214
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
99750025
—
NH
Enumeration date
07/08/2005
Last updated
11/01/2019
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