Provider Demographics
NPI:1679965271
Name:BINETTE, AMY (CDA, RDH)
Entity Type:Individual
Prefix:MISS
First Name:AMY
Middle Name:
Last Name:BINETTE
Suffix:
Gender:F
Credentials:CDA, RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:679 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-3749
Mailing Address - Country:US
Mailing Address - Phone:603-620-1099
Mailing Address - Fax:
Practice Address - Street 1:679 MAPLE ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-3749
Practice Address - Country:US
Practice Address - Phone:603-620-1099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-19
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH01910124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist