Provider Demographics
NPI:1083467864
Name:AGATA A. BARTELS DMD, PLLC
Entity Type:Organization
Organization Name:AGATA A. BARTELS DMD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:AGATA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BARTELS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MS
Authorized Official - Phone:646-369-4221
Mailing Address - Street 1:1F COMMONS DR UNIT 36
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-3475
Mailing Address - Country:US
Mailing Address - Phone:603-434-0190
Mailing Address - Fax:
Practice Address - Street 1:1F COMMONS DR UNIT 36
Practice Address - Street 2:
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-3475
Practice Address - Country:US
Practice Address - Phone:603-434-0190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty