Provider Demographics
NPI:1043421670
Name:DIANE E BENOIT
Entity Type:Organization
Organization Name:DIANE E BENOIT
Other - Org Name:CAPITAL AREA DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:E
Authorized Official - Last Name:BENOIT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:603-228-1771
Mailing Address - Street 1:29 GREEN ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-4021
Mailing Address - Country:US
Mailing Address - Phone:603-228-1771
Mailing Address - Fax:603-228-2042
Practice Address - Street 1:29 GREEN ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-4021
Practice Address - Country:US
Practice Address - Phone:603-228-1771
Practice Address - Fax:603-228-2042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH24721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty