Provider Demographics
NPI:1790075786
Name:HOERTDOERFER DENTISTRY, PLLC
Entity Type:Organization
Organization Name:HOERTDOERFER DENTISTRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:HOERTDOERFER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:603-669-1251
Mailing Address - Street 1:4 ELLIOT WAY
Mailing Address - Street 2:SUITE 306
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-3547
Mailing Address - Country:US
Mailing Address - Phone:603-669-1251
Mailing Address - Fax:
Practice Address - Street 1:4 ELLIOT WAY
Practice Address - Street 2:SUITE 306
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-3547
Practice Address - Country:US
Practice Address - Phone:603-669-1251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty