Organization
LIFETIME DENTAL PROFESSIONALS OF NEW HAMPSHIRE, P.C.
Active
Parent organization
LIFETIME DENTAL PROFESSIONALS OF NEW HAM
Other names
Main Street Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFETIME DENTAL PROFESSIONALS OF NEW HAM
Authorized official
LORI EDMONDS (CREDENTIALING COORDINATOR)
(217) 540-8468
Entity
Organization
Contact information
Practice address
107 MAIN STREET, PLYMOUTH, NH 03264
(603) 536-4009
(603) 536-1033
Mailing address
107 MAIN STREET, PLYMOUTH, NH 03264
(603) 536-4009
(603) 536-1033
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NH
1223G0001X
General Practice Dentistry
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30300441
—
NH
Enumeration date
04/13/2007
Last updated
03/29/2016
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