Provider Demographics
NPI:1588829725
Name:YADANI, FOUAD (DMD)
Entity Type:Individual
Prefix:DR
First Name:FOUAD
Middle Name:
Last Name:YADANI
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 1:2305 BROWN AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-6813
Mailing Address - Country:US
Mailing Address - Phone:603-505-4440
Mailing Address - Fax:603-232-3980
Practice Address - Street 1:2305 BROWN AVE STE 1
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-6813
Practice Address - Country:US
Practice Address - Phone:603-505-4440
Practice Address - Fax:603-232-3980
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-28
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH036731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice