Individual
DR. ANGELA JEAN SANTAVICCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
367 STATE ROUTE 120, UNIT C, LEBANON, NH 03766-1430
(603) 643-4142
(603) 643-1740
Mailing address
80 CHURCH ST, LEBANON, NH 03766-1620
(603) 448-2750
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2648
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2648
NH DENTAL LICENSE
NH
05
—
30310640
—
NH
Enumeration date
03/09/2007
Last updated
07/09/2007
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