Provider Demographics
NPI: | 1801029277 |
---|---|
Name: | SEACOAST ORTHODONTICS |
Entity Type: | Organization |
Organization Name: | SEACOAST ORTHODONTICS |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | ORTHODONTIST |
Authorized Official - Prefix: | |
Authorized Official - First Name: | TIMOTHY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | FINELLI |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DDS |
Authorized Official - Phone: | 603-964-2220 |
Mailing Address - Street 1: | 45 LAFAYETTE RD |
Mailing Address - Street 2: | SUITE 14 |
Mailing Address - City: | NORTH HAMPTON |
Mailing Address - State: | NH |
Mailing Address - Zip Code: | 03862-2451 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 603-964-2220 |
Mailing Address - Fax: | 603-964-2244 |
Practice Address - Street 1: | 45 LAFAYETTE RD |
Practice Address - Street 2: | SUITE 14 |
Practice Address - City: | NORTH HAMPTON |
Practice Address - State: | NH |
Practice Address - Zip Code: | 03862-2451 |
Practice Address - Country: | US |
Practice Address - Phone: | 603-964-2220 |
Practice Address - Fax: | 603-964-2244 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2009-09-01 |
Last Update Date: | 2009-09-01 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NH | 03640 | 261QD0000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QD0000X | Ambulatory Health Care Facilities | Clinic/Center | Dental |