Provider Demographics
NPI:1710499850
Name:FOUAD YADANI, DMD
Entity Type:Organization
Organization Name:FOUAD YADANI, DMD
Other - Org Name:MANCHESTER ADVANCED DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FOUAD
Authorized Official - Middle Name:
Authorized Official - Last Name:YADANI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:603-505-4440
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-30
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty