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Individual

TRACY POGAL-SUSSMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
72 S RIVER RD, BEDFORD, NH 03110-6759
(603) 624-3900
Mailing address
72 S RIVER RD, BEDFORD, NH 03110-6759

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
04046
NH

Other

Enumeration date
05/21/2014
Last updated
05/21/2014
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