Provider Demographics
NPI:1235153909
Name:DAVID B STAPLES DDS & NICHOLAS KANELOS JR DMD
Entity Type:Organization
Organization Name:DAVID B STAPLES DDS & NICHOLAS KANELOS JR DMD
Other - Org Name:GARRISON FAMILY DENTAL
Other - Org Type:Other Name
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:KANELOS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:603-742-8844
Mailing Address - Street 1:801 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-2529
Mailing Address - Country:US
Mailing Address - Phone:603-742-8844
Mailing Address - Fax:603-749-8882
Practice Address - Street 1:801 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-2529
Practice Address - Country:US
Practice Address - Phone:603-742-8844
Practice Address - Fax:603-749-8882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty