Provider Demographics
NPI:1639353873
Name:HAMPSHIRE FAMILY DENTAL
Entity Type:Organization
Organization Name:HAMPSHIRE FAMILY DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:JANET
Authorized Official - Last Name:BROWN LOOSMANN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:603-895-5600
Mailing Address - Street 1:61 ROUTE #27
Mailing Address - Street 2:PO BOX 958
Mailing Address - City:RAYMOND
Mailing Address - State:NH
Mailing Address - Zip Code:03077
Mailing Address - Country:US
Mailing Address - Phone:603-895-5600
Mailing Address - Fax:603-895-8887
Practice Address - Street 1:61 ROUTE 27
Practice Address - Street 2:
Practice Address - City:RAYMOND
Practice Address - State:NH
Practice Address - Zip Code:03077
Practice Address - Country:US
Practice Address - Phone:603-895-5600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherTIN