Provider Demographics
NPI:1003391590
Name:COLE, ANNETTE LISA (RDH)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:LISA
Last Name:COLE
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:262 COTTAGE ST STE 230
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:NH
Mailing Address - Zip Code:03561-4143
Mailing Address - Country:US
Mailing Address - Phone:603-259-3700
Mailing Address - Fax:603-444-0945
Practice Address - Street 1:262 COTTAGE ST STE 230
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:NH
Practice Address - Zip Code:03561-4143
Practice Address - Country:US
Practice Address - Phone:603-259-3700
Practice Address - Fax:603-444-0945
Is Sole Proprietor?:No
Enumeration Date:2018-10-01
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH01839124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist