Provider Demographics
NPI:1669508701
Name:CIMON, RALPH JOSEPH III (DMD)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:JOSEPH
Last Name:CIMON
Suffix:III
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 FIELDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NH
Mailing Address - Zip Code:03049-6564
Mailing Address - Country:US
Mailing Address - Phone:603-465-3080
Mailing Address - Fax:
Practice Address - Street 1:29 GREEN ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-4021
Practice Address - Country:US
Practice Address - Phone:603-228-1771
Practice Address - Fax:603-228-2042
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH34421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3442OtherSTATE DENTAL LICENSE