Provider Demographics
NPI:1891723318
Name:BARTLETT, DANA N (DMD)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:N
Last Name:BARTLETT
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:PO BOX 16
Mailing Address - Street 2:
Mailing Address - City:COLEBROOK
Mailing Address - State:NH
Mailing Address - Zip Code:03576-0016
Mailing Address - Country:US
Mailing Address - Phone:603-237-5555
Mailing Address - Fax:603-237-5563
Practice Address - Street 1:75 S MAIN ST
Practice Address - Street 2:
Practice Address - City:COLEBROOK
Practice Address - State:NH
Practice Address - Zip Code:03576-3600
Practice Address - Country:US
Practice Address - Phone:603-237-5555
Practice Address - Fax:603-237-5563
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH13961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30317712Medicaid
NH30302674Medicaid