Provider Demographics
NPI:1437379708
Name:VILLAGE DENTAL OF NEW ENGLAND PLLC
Entity Type:Organization
Organization Name:VILLAGE DENTAL OF NEW ENGLAND PLLC
Other - Org Name:LEONARD E DI PAOLO DDS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:E
Authorized Official - Last Name:DI PAOLO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:603-382-1585
Mailing Address - Street 1:89 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PLAISTOW
Mailing Address - State:NH
Mailing Address - Zip Code:03865-3010
Mailing Address - Country:US
Mailing Address - Phone:603-382-1585
Mailing Address - Fax:603-382-2052
Practice Address - Street 1:89 MAIN ST
Practice Address - Street 2:
Practice Address - City:PLAISTOW
Practice Address - State:NH
Practice Address - Zip Code:03865-3010
Practice Address - Country:US
Practice Address - Phone:603-382-1585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-27
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2072122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty