Provider Demographics
NPI:1902862931
Name:FILOCOMA, DEBRA (DDS)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:
Last Name:FILOCOMA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 TOBEY LN
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-5710
Mailing Address - Country:US
Mailing Address - Phone:978-470-3417
Mailing Address - Fax:
Practice Address - Street 1:150 GRIFFIN RD
Practice Address - Street 2:SUITE 2
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-7131
Practice Address - Country:US
Practice Address - Phone:603-436-2204
Practice Address - Fax:603-436-4158
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH26121223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30007754Medicaid