Provider Demographics
NPI:1497166367
Name:SEABROOK DENTAL CARE CORP
Entity Type:Organization
Organization Name:SEABROOK DENTAL CARE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RIDHIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOYAL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:603-898-9180
Mailing Address - Street 1:12 STILES RD STE 205
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-2881
Mailing Address - Country:US
Mailing Address - Phone:603-898-9180
Mailing Address - Fax:603-389-9257
Practice Address - Street 1:12 STILES RD
Practice Address - Street 2:SUITE 205
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-2879
Practice Address - Country:US
Practice Address - Phone:603-898-9180
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-14
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH037261223G0001X
NH040141223G0001X
NH034341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty