Organization
GRANITE STATE ORAL SURGERY PLLC
Active
Organization
GRANITE STATE ORAL SURGERY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SALMAN AYUB MALIK D.M.D., M.D. (OWNER)
(603) 432-3308
Entity
Organization
Contact information
Practice address
80 NASHUA RD, BUILDING C, LONDONDERRY, NH 03053-3426
(603) 432-3308
(603) 425-6165
Mailing address
80 NASHUA RD, BUILDING C, LONDONDERRY, NH 03053-3426
(603) 432-3308
(603) 425-6165
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
3025
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0206381Y0NH01
ANTHEM ID
NH
01
—
1417977737
TYPE 1 NPI
NH
05
—
30312701
—
NH
Enumeration date
05/30/2007
Last updated
08/22/2020
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