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Organization

ELLIOT PROFESSIONAL SERVICES

Active
Parent organization
ELLIOT PROFESSIONAL SERVICES
Other names
ELLIOT OMS CENTER
Organization subpart
Yes

Provider details

NPI number
Legal business name
ELLIOT PROFESSIONAL SERVICES
Authorized official
RICHARD P. HERMAN (DIRECTOR OF OPERATIONS AND FINANCE)
(603) 663-4904
Entity
Organization

Contact information

Practice address
1 ELLIOT WAY, ELLIOT OMS CENTER, MANCHESTER, NH 03103-3502
(603) 625-8462
(603) 669-2711
Mailing address
1 ELLIOT WAY, ELLIOT OMS CENTER, MANCHESTER, NH 03103-3502
(603) 625-8462
(603) 669-2711

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30313860
NH
01
CK3360
RR MEDICARE
NH
Enumeration date
11/28/2005
Last updated
06/20/2008
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