Organization
ANGELA J SANTAVICCA DDS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODI L BERGERON (PRACTICE MANAGER)
(603) 643-4142
Entity
Organization
Contact information
Practice address
367 STATE ROUTE 120, UNIT C, LEBANON, NH 03766-1430
(603) 643-4142
(603) 643-1740
Mailing address
367 STATE ROUTE 120, UNIT C, LEBANON, NH 03766-1430
(603) 643-4142
(603) 643-1740
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2648
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30310640
—
NH
Enumeration date
05/14/2007
Last updated
08/22/2020
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