Provider Demographics
NPI:1467500520
Name:NASHUA IMPLANT RECONSTRUCTIVE CENTER PC
Entity Type:Organization
Organization Name:NASHUA IMPLANT RECONSTRUCTIVE CENTER PC
Other - Org Name:NASHUA IMPLANT CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT AND OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHOK
Authorized Official - Middle Name:K
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MDS, DMD
Authorized Official - Phone:603-888-8100
Mailing Address - Street 1:7 F TAGGART DR
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060
Mailing Address - Country:US
Mailing Address - Phone:603-888-8100
Mailing Address - Fax:603-888-7200
Practice Address - Street 1:7 F TAGGART DR
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060
Practice Address - Country:US
Practice Address - Phone:603-888-8100
Practice Address - Fax:603-888-7200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3204261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center