Organization
LEBANON DENTAL CENTRE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELINA SANTA MARIA (ADMINISTRATOR)
(603) 448-2100
Entity
Organization
Contact information
Practice address
31 OLD ETNA RD, SUITE 4, LEBANON, NH 03766-1933
(603) 448-2100
(603) 443-9958
Mailing address
31 OLD ETNA RD, SUITE 4, LEBANON, NH 03766-1933
(603) 448-2100
(603) 443-9958
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3516
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003969023
NPI
—
01
—
1114950607
NPI
CT
05
—
30314064
—
NH
Enumeration date
06/14/2007
Last updated
08/22/2020
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