Provider Demographics
NPI:1467126623
Name:NEDG - WINDHAM PLLC
Entity Type:Organization
Organization Name:NEDG - WINDHAM PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARGARITA
Authorized Official - Middle Name:
Authorized Official - Last Name:PANAJOTI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-281-6464
Mailing Address - Street 1:257 TURNPIKE RD STE 110
Mailing Address - Street 2:
Mailing Address - City:SOUTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01772-1791
Mailing Address - Country:US
Mailing Address - Phone:508-281-6464
Mailing Address - Fax:508-281-6677
Practice Address - Street 1:1 DELAHUNTY DR # 2
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:NH
Practice Address - Zip Code:03087-2019
Practice Address - Country:US
Practice Address - Phone:508-281-6464
Practice Address - Fax:508-281-6464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-02
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH04649OtherDENTAL LICENSE