Provider Demographics
NPI:1871669101
Name:ADVANCED ENDODONTICS
Entity Type:Organization
Organization Name:ADVANCED ENDODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:WURZER
Authorized Official - Last Name:NEFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-637-1046
Mailing Address - Street 1:18 CONSTITUTION DR
Mailing Address - Street 2:SUITE 5
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6076
Mailing Address - Country:US
Mailing Address - Phone:603-637-1046
Mailing Address - Fax:603-637-1047
Practice Address - Street 1:18 CONSTITUTION DR
Practice Address - Street 2:SUITE 5
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6076
Practice Address - Country:US
Practice Address - Phone:603-637-1046
Practice Address - Fax:603-637-1047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH32531223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty