Provider Demographics
NPI:1831130343
Name:BRACKETT, JAMES D (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:D
Last Name:BRACKETT
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 1:50 LYME RD
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03755-1209
Mailing Address - Country:US
Mailing Address - Phone:603-643-3224
Mailing Address - Fax:603-643-6812
Practice Address - Street 1:50 LYME RD
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:NH
Practice Address - Zip Code:03755-1209
Practice Address - Country:US
Practice Address - Phone:603-643-3224
Practice Address - Fax:603-643-6812
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH10441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice