Organization
ELLIOT PROFESSIONAL SERVICES
Active
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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