Provider Demographics
NPI:1114196409
Name:TROY SCHRUPP, D.D.S., P.L.L.C.
Entity Type:Organization
Organization Name:TROY SCHRUPP, D.D.S., P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:SCHRUPP
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:603-528-0400
Mailing Address - Street 1:60 BELKNAP MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:GILFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03249-6809
Mailing Address - Country:US
Mailing Address - Phone:603-528-0400
Mailing Address - Fax:603-528-0015
Practice Address - Street 1:60 BELKNAP MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:GILFORD
Practice Address - State:NH
Practice Address - Zip Code:03249-6809
Practice Address - Country:US
Practice Address - Phone:603-528-0400
Practice Address - Fax:603-528-0015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-21
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNH2657122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30313707Medicaid