Individual
ROBERT F. PROVENCHER JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1 ELLIOT WAY, 2ND FLOOR, MANCHESTER, NH 03103-3502
(603) 625-8462
(603) 669-2711
Mailing address
1 ELLIOT WAY, 2ND FLOOR, MANCHESTER, NH 03103-3502
(603) 625-8462
(603) 669-2711
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
1141
NH
Other
Enumeration date
11/28/2005
Last updated
07/09/2007
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