Provider Demographics
NPI: | 1255319315 |
---|---|
Name: | STEPHEN LEE LANGLOIS |
Entity Type: | Organization |
Organization Name: | STEPHEN LEE LANGLOIS |
Other - Org Name: | S.L. LANGLOIS, DMD, PLLC |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | MEMBER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | STEPHEN |
Authorized Official - Middle Name: | L |
Authorized Official - Last Name: | LANGLOIS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DMD, FAGD |
Authorized Official - Phone: | 603-644-3368 |
Mailing Address - Street 1: | 765 S MAIN ST |
Mailing Address - Street 2: | SUITE 102 |
Mailing Address - City: | MANCHESTER |
Mailing Address - State: | NH |
Mailing Address - Zip Code: | 03102-5141 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 765 S MAIN ST |
Practice Address - Street 2: | SUITE 102 |
Practice Address - City: | MANCHESTER |
Practice Address - State: | NH |
Practice Address - Zip Code: | 03102-5141 |
Practice Address - Country: | US |
Practice Address - Phone: | 603-644-3368 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-01-08 |
Last Update Date: | 2008-06-18 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NH | 1871 | 122300000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 122300000X | Dental Providers | Dentist | Group - Single Specialty |