Organization
PITTSFIELD FAMILY DENTAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FREDRICK M VEGA D.D.S. (MANAGING MEMBER)
(603) 435-8030
Entity
Organization
Contact information
Practice address
50 MANCHESTER ST, PITTSFIELD, NH 03263-3401
(603) 435-8030
(603) 435-8107
Mailing address
50 MANCHESTER ST, PITTSFIELD, NH 03263-3401
(603) 435-8030
(603) 435-8107
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1857
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30007856
—
NH
Enumeration date
11/16/2011
Last updated
11/16/2011
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