Provider Demographics
NPI:1417401878
Name:MAGDALENA SOUTCHEVA DMD PC D/B/A COASTAL DENTAL ASSOCIATES
Entity Type:Organization
Organization Name:MAGDALENA SOUTCHEVA DMD PC D/B/A COASTAL DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MAGDALENA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOUTCHEVA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:603-436-6997
Mailing Address - Street 1:2837 LAFAYETTE RD
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-5648
Mailing Address - Country:US
Mailing Address - Phone:603-436-6997
Mailing Address - Fax:603-436-6964
Practice Address - Street 1:2837 LAFAYETTE RD
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-5648
Practice Address - Country:US
Practice Address - Phone:603-436-6997
Practice Address - Fax:603-436-6964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-15
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service