Provider Demographics
NPI:1154637726
Name:SEVIGNY FAMILY DENTAL PLLC DBA CONWAY FAMILY DENTAL CARE
Entity Type:Organization
Organization Name:SEVIGNY FAMILY DENTAL PLLC DBA CONWAY FAMILY DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:TAD
Authorized Official - Middle Name:
Authorized Official - Last Name:FURTADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-447-3888
Mailing Address - Street 1:27 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:NH
Mailing Address - Zip Code:03818-6044
Mailing Address - Country:US
Mailing Address - Phone:603-447-3888
Mailing Address - Fax:800-348-3471
Practice Address - Street 1:27 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:NH
Practice Address - Zip Code:03818-6044
Practice Address - Country:US
Practice Address - Phone:603-447-3888
Practice Address - Fax:800-348-3471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-20
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty