Organization
CHESTNUT FAMILY DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN ANNE KENNEY (OFFICE MANAGER)
(603) 622-7173
Entity
Organization
Contact information
Practice address
745 CHESTNUT ST, MANCHESTER, NH 03104-3002
(603) 622-7173
(603) 668-2709
Mailing address
745 CHESTNUT ST, MANCHESTER, NH 03104-3002
(603) 622-7173
(603) 668-2709
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
3147
NH
261QD0000X
Dental Clinic/Center
3178
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30301213
—
NH
05
—
30303489
—
NH
Enumeration date
05/01/2007
Last updated
08/22/2020
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