Provider Demographics
NPI:1568407922
Name:SANTANA-PAINE, CARMEN VIRGINIA (DMD)
Entity Type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:VIRGINIA
Last Name:SANTANA-PAINE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 MANCHESTER SQ
Mailing Address - Street 2:SUITE 215
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-2889
Mailing Address - Country:US
Mailing Address - Phone:603-610-8765
Mailing Address - Fax:603-610-8766
Practice Address - Street 1:14 MANCHESTER SQ
Practice Address - Street 2:SUITE 215
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-2889
Practice Address - Country:US
Practice Address - Phone:603-610-8765
Practice Address - Fax:603-610-8766
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH34511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice