Organization
RAYNOR DENTAL PETERBOROUGH, PLLC
Active
Parent organization
SPOONWOOD DENTAL PARTNERS, PLLC
Other names
Spoonwood Dental Partners LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPOONWOOD DENTAL PARTNERS, PLLC
Authorized official
DR. JASON RAYNOR DMD (DENTIST/OWNER)
(603) 352-0006
Entity
Organization
Contact information
Practice address
454 OLD STREET RD, PETERBOROUGH, NH 03458-1200
(603) 924-9688
Mailing address
650 COURT ST, KEENE, NH 03431-1758
(603) 352-0006
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1134605116
NPI
—
01
—
1255990255
NPI
NH
01
—
1275659237
NPI
—
01
—
1306339593
NPI
—
01
—
1790915957
NPI
—
01
—
1922294701
NPI
—
Enumeration date
07/13/2018
Last updated
06/21/2019
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