Provider Demographics
NPI:1679137228
Name:OASIS DENTAL, P.C.
Entity Type:Organization
Organization Name:OASIS DENTAL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLIVETTE
Authorized Official - Middle Name:X
Authorized Official - Last Name:SANTAMARIA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:603-641-5200
Mailing Address - Street 1:1525 S WILLOW ST UNIT 5
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-3209
Mailing Address - Country:US
Mailing Address - Phone:603-641-5200
Mailing Address - Fax:603-641-5200
Practice Address - Street 1:1525 S WILLOW ST UNIT 5
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-3209
Practice Address - Country:US
Practice Address - Phone:603-641-5200
Practice Address - Fax:603-641-5200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-30
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty