Organization
CAPITOL CENTER FOR ORAL & MAXILLOFACIAL SURGERY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD J ROSATO DMD (OWNER)
(603) 225-0008
Entity
Organization
Contact information
Practice address
129 WILTON RD, SUITE B, PETERBOROUGH, NH 03458-1749
(603) 784-5447
(603) 784-5449
Mailing address
6 LOUDON RD, SUITE 204, CONCORD, NH 03301-5321
(603) 225-0008
(603) 225-8120
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
3188
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02Y002478NH02
ANTHEM
NH
01
—
2027588
CIGNA HEALTHCARE
NH
05
—
30314308
—
NH
Enumeration date
05/09/2007
Last updated
08/14/2012
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