Provider Demographics
NPI:1821499922
Name:AMER, MARCO (DMD)
Entity Type:Individual
Prefix:
First Name:MARCO
Middle Name:
Last Name:AMER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 PULPIT RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-4220
Mailing Address - Country:US
Mailing Address - Phone:631-560-7834
Mailing Address - Fax:
Practice Address - Street 1:801 ELM ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-2103
Practice Address - Country:US
Practice Address - Phone:603-623-7800
Practice Address - Fax:603-935-9685
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1856737122300000X
NH041501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHNHL15214156OtherNEW HAMPSHIRE STATE