Provider Demographics
NPI:1194016246
Name:BOTTRILL, ADAM JOASH (DMD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:JOASH
Last Name:BOTTRILL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 MARCH FARM WAY UNIT A
Mailing Address - Street 2:
Mailing Address - City:GREENLAND
Mailing Address - State:NH
Mailing Address - Zip Code:03840-6235
Mailing Address - Country:US
Mailing Address - Phone:603-436-2204
Mailing Address - Fax:
Practice Address - Street 1:13 MARCH FARM WAY UNIT A
Practice Address - Street 2:
Practice Address - City:GREENLAND
Practice Address - State:NH
Practice Address - Zip Code:03840-6235
Practice Address - Country:US
Practice Address - Phone:603-319-4101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-25
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH038491223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry