Organization
DENTAL SPECIALTIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXA STAPIN (HR SPECIALIST)
(508) 872-3072
Entity
Organization
Contact information
Practice address
4 VINTON ST, MANCHESTER, NH 03103-3928
(603) 810-0515
Mailing address
5 MOUNT ROYAL AVE STE 300, MARLBOROUGH, MA 01752-1900
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
03/10/2026
Last updated
03/10/2026
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