Provider Demographics
NPI:1003005992
Name:NATALIE ACCOMANDO DMD PLLC
Entity Type:Organization
Organization Name:NATALIE ACCOMANDO DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ACCOMANDO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:603-645-8510
Mailing Address - Street 1:1361 ELM ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101-1324
Mailing Address - Country:US
Mailing Address - Phone:603-645-8510
Mailing Address - Fax:603-645-8512
Practice Address - Street 1:1361 ELM ST
Practice Address - Street 2:SUITE 300
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-1324
Practice Address - Country:US
Practice Address - Phone:603-645-8510
Practice Address - Fax:603-645-8512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-17
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH31441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30302547Medicaid