Provider Demographics
NPI:1588680219
Name:POLLACK, TODD GLENN (DMD)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:GLENN
Last Name:POLLACK
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 1:6 CONCORD ST
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03064-2355
Mailing Address - Country:US
Mailing Address - Phone:603-882-8000
Mailing Address - Fax:
Practice Address - Street 1:6 CONCORD ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03064-2355
Practice Address - Country:US
Practice Address - Phone:603-882-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2009-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH24181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice