Provider Demographics
NPI:1538288469
Name:ALBERT, VINCENT M (DMD)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:M
Last Name:ALBERT
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 ROUTE 108
Mailing Address - Street 2:
Mailing Address - City:SOMERSWORTH
Mailing Address - State:NH
Mailing Address - Zip Code:03878-1512
Mailing Address - Country:US
Mailing Address - Phone:602-692-6598
Mailing Address - Fax:603-692-6935
Practice Address - Street 1:259 ROUTE 108
Practice Address - Street 2:
Practice Address - City:SOMERSWORTH
Practice Address - State:NH
Practice Address - Zip Code:03878-1512
Practice Address - Country:US
Practice Address - Phone:602-692-6598
Practice Address - Fax:603-692-6935
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH30231223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0207167Y0NH01OtherANTHEM BLUE CROSS
NHU42934Medicare UPIN
NHRE4598Medicare ID - Type Unspecified