Provider Demographics
NPI:1083023063
Name:EBRIGHT, ALYSSA MARY (DMD)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:MARY
Last Name:EBRIGHT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 GILCREAST RD
Mailing Address - Street 2:STE 1004
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-3518
Mailing Address - Country:US
Mailing Address - Phone:603-434-8800
Mailing Address - Fax:
Practice Address - Street 1:151 MAIN ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-2725
Practice Address - Country:US
Practice Address - Phone:603-886-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-04
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH04064122300000X
MADN1856638122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist