Provider Demographics
NPI:1245703511
Name:URGENT DENTAL CARE OF SOMERSWORTH, PLLC
Entity type:Organization
Organization Name:URGENT DENTAL CARE OF SOMERSWORTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:SUDATI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:603-841-2969
Mailing Address - Street 1:259 ROUTE 108
Mailing Address - Street 2:
Mailing Address - City:SOMERSWORTH
Mailing Address - State:NH
Mailing Address - Zip Code:03878-1512
Mailing Address - Country:US
Mailing Address - Phone:603-841-2969
Mailing Address - Fax:
Practice Address - Street 1:259 ROUTE 108
Practice Address - Street 2:
Practice Address - City:SOMERSWORTH
Practice Address - State:NH
Practice Address - Zip Code:03878-1512
Practice Address - Country:US
Practice Address - Phone:603-841-2700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-09
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental