Organization
NORTHEASTERN PEDIATRIC DENTAL
Active
Parent organization
NORTHEASTERN PEDIATRIC DENTAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTHEASTERN PEDIATRIC DENTAL
Authorized official
MINA H KALALI DMD (DMD OWNER)
(603) 880-5002
Entity
Organization
Contact information
Practice address
78 NORTHEASTERN BLVD, SUITE 6, NASHUA, NH 03062
(603) 880-5002
(603) 880-1877
Mailing address
78 NORTHEASTERN BLVD, SUITE 6, NASHUA, NH 03062
(603) 880-5002
(603) 880-1877
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
3374
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30303168
—
NH
Enumeration date
02/20/2008
Last updated
02/20/2008
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