Provider Demographics
NPI:1417162967
Name:DONALD M. HUMEN, DMD,PA
Entity Type:Organization
Organization Name:DONALD M. HUMEN, DMD,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:M
Authorized Official - Last Name:HUMEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:603-882-6100
Mailing Address - Street 1:29 RIVERSIDE STREET
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062
Mailing Address - Country:US
Mailing Address - Phone:603-882-6100
Mailing Address - Fax:603-882-5106
Practice Address - Street 1:29 RIVERSIDE STREET
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062
Practice Address - Country:US
Practice Address - Phone:603-882-6100
Practice Address - Fax:603-882-5106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH12111223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty