Provider Demographics
NPI:1134410947
Name:3 STONE DENTAL
Entity type:Organization
Organization Name:3 STONE DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS/FINANCE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SANTA MARIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-641-5200
Mailing Address - Street 1:1525 S WILLOW ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-3209
Mailing Address - Country:US
Mailing Address - Phone:603-641-5520
Mailing Address - Fax:603-641-5201
Practice Address - Street 1:1525 S WILLOW ST
Practice Address - Street 2:SUITE 5
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-3209
Practice Address - Country:US
Practice Address - Phone:603-641-5200
Practice Address - Fax:603-641-5201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-27
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH35161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty